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Prolonged Survival after Recurrence in HCC Resected Patients Using Repeated Curative Therapies: Never Give Up!
Cyprien Toubert1, Boris Guiu2, Bader Al Taweel1
1Department of HBP Surgery and Liver Transplantation, Montpellier University Hospital, University of Montpellier, 34295 Montpellier, France.
Cancers
|January 8, 2023
Summary
Surgical resection offers the best outcome for hepatocellular carcinoma (HCC). Identifying prognostic factors for survival after recurrence is crucial for improving patient outcomes and guiding treatment decisions.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Hepatocellular Carcinoma Research
Background:
- Surgical resection is the primary treatment for hepatocellular carcinoma (HCC), but recurrence is common.
- Limited data exist regarding patient survival following HCC recurrence after hepatectomy.
- Understanding prognostic factors is essential for optimizing post-recurrence management.
Purpose of the Study:
- To identify prognostic factors influencing survival after tumor recurrence in patients with HCC.
- To analyze the impact of recurrence timing and treatment on overall survival.
- To provide insights for improving the prognosis of HCC patients post-resection.
Main Methods:
- Retrospective analysis of 387 patients undergoing hepatectomy for HCC between 2000 and 2016.
- Univariate and multivariate analyses to determine independent prognostic factors for survival after recurrence (SAR).
- Subgroup analysis based on early versus late recurrence and treatment modalities.
Main Results:
- Hepatocellular carcinoma recurrence was observed in 58.4% of patients, with a median SAR of 26 months.
- Independent prognostic factors for SAR included micro-vascular invasion, initial tumor size, preoperative AFP, albumin, platelets, gender, recurrence characteristics, time to recurrence, Child-Pugh score, and treatment at recurrence.
- Early recurrence was linked to decreased SAR, while overall survival did not significantly differ between recurring and non-recurring patients with early or late recurrence, especially when curative treatments were administered.
Conclusions:
- Micro-vascular invasion, initial tumor characteristics, preoperative biomarkers, recurrence patterns, and treatment at recurrence significantly impact survival after HCC recurrence.
- Aggressive and timely treatments, including liver transplantation, repeat hepatectomy, or thermal ablation, are critical for improving the prognosis of HCC patients.
- The timing of recurrence and the application of curative treatments play a vital role in the long-term survival of patients with hepatocellular carcinoma.
