Risk Factors, Patterns, and Outcomes of Late Recurrence After Liver Resection for Hepatocellular Carcinoma: A...

Area of Science:

• Hepatobiliary surgery
• Surgical oncology
• Gastroenterology

Background:

• Late recurrence, defined as occurring more than two years post-surgery, is a significant concern after liver resection for hepatocellular carcinoma (HCC).
• Understanding the factors contributing to late recurrence is crucial for improving patient outcomes.

Purpose of the Study:

• To identify risk factors associated with late recurrence of HCC after curative liver resection.
• To analyze patterns, treatments, and survival outcomes for patients experiencing late HCC recurrence.

Main Methods:

• A multicenter retrospective analysis involving 734 patients who underwent curative liver resection for HCC between 2001 and 2015.
• Statistical analysis, including univariate and multivariate Cox regression, was used to determine risk factors and survival predictors.

Main Results:

• Over 41% of patients developed late recurrence, with male sex, cirrhosis, multiple tumors, satellite nodules, larger tumor size, and vascular invasion identified as independent risk factors.
• Intrahepatic recurrence was the predominant pattern. Potentially curative treatments were administered to over 54% of patients with late recurrence.
• Regular postoperative surveillance and potentially curative treatments were associated with improved overall survival for patients with late recurrence.

Conclusions:

• Late HCC recurrence is associated with specific patient and tumor characteristics, emphasizing the need for tailored follow-up strategies.
• Targeted surveillance for intrahepatic recurrence after two years is recommended.
• Postoperative surveillance enhances the likelihood of receiving curative treatments and improves survival outcomes for patients with late recurrence.