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KMID : 1188320210150030420
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Gut and Liver
2021 Volume.15 No. 3 p.420 ~ p.429
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Change in the Recurrence Pattern and Predictors over Time after Complete Cure of Hepatocellular Carcinoma
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Lee Han-Ah
Lee Young-Sun
Kim Beom-Kyung
Jung Young-Kul
Kim Seung-Up
Park Jun-Yong
Kim Ji-Hoon
An Hyung-Gin
Kim Do-Young
Yim Hyung-Joon
Ahn Sang-Hoon
Yeon Jong-Eun
Byun Kwan-Soo
Han Kwang-Hyub
Um Soon-Ho
Seo Yeon-Seok
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Abstract
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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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KEYWORD
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Recurrence, Risk factor, Barcelona Clinic Liver Cancer stage A, Carcinoma, hepatocellular
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