Change in the Recurrence Pattern and Predictors over Time after Complete Cure of Hepatocellular Carcinoma
- Authors
- Lee, Han Ah; Lee, Young-Sun; Kim, Beom Kyung; Jung, Young Kul; Kim, Seung Up; Park, Jun Yong; Kim, Ji Hoon; An, Hyunggin; Kim, Do Young; Yim, Hyung Joon; Ahn, Sang Hoon; Yeon, Jong Eun; Byun, Kwan Soo; Han, Kwang-Hyub; Um, Soon Ho; Seo, Yeon Seok
- Issue Date
- 5월-2021
- Publisher
- EDITORIAL OFFICE GUT & LIVER
- Keywords
- Recurrence; Risk factor; Barcelona Clinic Liver Cancer stage A; Carcinoma, hepatocellular
- Citation
- GUT AND LIVER, v.15, no.3, pp.420 - 429
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- GUT AND LIVER
- Volume
- 15
- Number
- 3
- Start Page
- 420
- End Page
- 429
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/128112
- DOI
- 10.5009/gnl20101
- ISSN
- 1976-2283
- 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.
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