Change in the recurrence pattern and predictors over time after complete cure of hepatocellular carcinoma

Han Ah Lee, Young Sun Lee, Beom Kyung Kim, Young Kul Jung, Seung Up Kim, Jun Yong Park, Ji Hoon Kim, Hyunggin An, Do Young Kim, Hyung Joon Yim, Sang Hoon Ahn, Jong Eun Yeon, Kwan Soo Byun, Kwang Hyub Han, Soon Ho Um, Yeon Seok Seo

Research output: Contribution to journalArticlepeer-review

Abstract

Background/Aims: We investigated changes in recurrence rates and significant recurrence predictors over time after complete cure of hepatocellular carcinoma (HCC). Methods: A total of 1,491 patients with first-time diagnosis of Barcelona Clinic Liver Cancer stage A HCC, completely cured by treatment between 2007 and 2016, were recruited from two Korean tertiary institutes. Results: The mean age of the population (1,144 men and 347 women) was 58.6 years. Of the total population, 914 patients (61.3%) had liver cirrhosis. Nine-hundred and forty-one (63.1%) and 550 (36.9%) patients were treated with surgical resection and radiofrequency ablation (RFA), respectively. One-year cumulative incidences of HCC recurrence were 14.3%, 9.9%, and 5.1% from the time of treatment, 3 years after treatment, and 5 years after treatment, respectively. Upon multivariate analysis, multiple tumors, maximal tumor size ≥3 cm, and high Model for End-Stage Liver Disease scores were independently associated with increased HCC recurrence risk from the time of treatment and 1 and 2 years after curative treatment (all p<0.05, except for maximal tumor size ≥3 cm for recurrence 2 years after treatment). Meanwhile, liver cirrhosis and RFA were independently associated with the increased HCC recurrence risk for almost all time points (liver cirrhosis: all p<0.05; RFA: all p<0.005 except for recurrence from 5 years after treatment). Conclusions: The recurrence rate of HCC after curative treatment gradually decreased over time. Two years after treatment, when tumor-related factors lose their prognostic implications, may be used as a cutoff to define the boundary between early and late recurrence of HCC. (Gut Liver 2021;15:420-429)

Original languageEnglish
Pages (from-to)420-429
Number of pages10
JournalGut and liver
Volume15
Issue number3
DOIs
Publication statusPublished - 2021

Bibliographical note

Publisher Copyright:
Copyright © Gut and Liver.

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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