Smoking as a Risk Factor for Very Late Recurrence in Surgically Resected Early-Stage Primary Hepatocellular Carcinoma

Area of Science:

• Hepatology
• Surgical Oncology
• Oncology

Background:

• The risk of hepatocellular carcinoma (HCC) recurrence between 5 and 10 years after curative hepatectomy is not well understood.
• Assessing very late recurrence and its prognostic factors is essential for long-term patient management.

Purpose of the Study:

• To determine the incidence of very late recurrence of HCC.
• To identify prognostic factors for very late recurrence in patients with 5-year recurrence-free survival.

Main Methods:

• Retrospective analysis of 337 patients with early-stage HCC who underwent primary tumor resection.
• Inclusion criteria: achieved more than 5 years' recurrence-free survival (RFS).

Main Results:

• Very late recurrence occurred in 77 patients (22.8%).
• Cumulative recurrence rates reached 16.6% by 8 years post-surgery.
• Smoking cessation was associated with a higher rate of very late recurrence-free survival.

Conclusions:

• High rates of very late HCC recurrence necessitate continued patient surveillance beyond 5 years post-hepatectomy.
• Smoking is a significant risk factor for very late HCC recurrence.
• Quitting smoking may mitigate the risk of very late recurrence in HCC patients.