Detailed Abstract
[Liver Oral Presentation 1 - Liver Disease/Surgery]
[LV OP 1-4] Risk factors, patterns, and outcomes of late recurrence after liver resection for patients with hepatocellular carcinoma (Analysis of a multicenter cohort over 15 years)
Xin-Fei XU1,2, Jiong-Jie YU1,2, Ju-Dong LI1,2, Hao XING1, Jun HAN1, Zhen-Li LI1, Han WU1, Han ZHANG1, Jian-Hong ZHONG3, Yi-Sheng HUANG4, Ya-Hao ZHOU5, Ting-Hao CHEN6, Hong WANG7, Wei-Min GU8, Feng SHEN1, Tian YANG1
1Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital of Second Military Medical University, China
2Department of Clinical Medicine, Second Military Medical University, China
3Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, China
4Department of Oncology, Affiliated Zhongshan Hospital of Guangdong Medical University, China
5Department of Hepatobiliary Surgery, Pu’er People’s Hospital, China
6Department of General Surgery, Ziyang First People’s Hospital, China
7Department of General Surgery, Liuyang People’s Hospital, China
8The First Department of General Surgery, The Fourth Hospital of Harbin, China tyl, China
Introduction : Late recurrence (> 2 years) after liver resection of hepatocellular carcinoma (HCC) is usually considered as multi-centric tumors or de novo cancer formation. We aimed to investigate risk factors, patterns and outcomes of late recurrence after HCC resection.
Methods : From a multicenter database from 2001 to 2015, 734 patients who were alive and recurrence-free at 2 years after curative resection of initial HCC were enrolled into this retrospective study. Univariate and multivariate Cox-regression analysis were used to identify independent risk factors of late recurrence. Patterns, treatments and outcomes of late recurrence were investigated and analyzed.
Results : During a median follow-up of 78.0 months after surgery, 303 patients (41.3%) developed late recurrence. Multivariate analysis revealed that cirrhosis, macroscopic vascular invasion, satellites, and tumor size > 5cm were independent risk factors of late recurrence. Among them, 273 (90.1%) were sole intrahepatic recurrence, 30 (9.9%) were concurrent intrahepatic and extrahepatic recurrence, and none of them was sole extrahepatic recurrence; 165 (54.4%) patients received curative treatments for recurrent HCC, including re-resection, transplantation and local ablation. Multivariate analysis showed regular postoperative surveillance and receiving curative treatments were two independent protective factors of prolonging survival for those patients with late recurrence.
Conclusions : Late recurrence is correlated with cirrhosis and certain tumor-related characteristics of initial HCC. The patterns of late recurrence suggest that postoperative surveillance after 2 years of surgery could be adjusted and more targeted. Regular postoperative surveillance improves the probability to receive curative treatments again, yielding to better outcomes for patients with late recurrence.
Methods : From a multicenter database from 2001 to 2015, 734 patients who were alive and recurrence-free at 2 years after curative resection of initial HCC were enrolled into this retrospective study. Univariate and multivariate Cox-regression analysis were used to identify independent risk factors of late recurrence. Patterns, treatments and outcomes of late recurrence were investigated and analyzed.
Results : During a median follow-up of 78.0 months after surgery, 303 patients (41.3%) developed late recurrence. Multivariate analysis revealed that cirrhosis, macroscopic vascular invasion, satellites, and tumor size > 5cm were independent risk factors of late recurrence. Among them, 273 (90.1%) were sole intrahepatic recurrence, 30 (9.9%) were concurrent intrahepatic and extrahepatic recurrence, and none of them was sole extrahepatic recurrence; 165 (54.4%) patients received curative treatments for recurrent HCC, including re-resection, transplantation and local ablation. Multivariate analysis showed regular postoperative surveillance and receiving curative treatments were two independent protective factors of prolonging survival for those patients with late recurrence.
Conclusions : Late recurrence is correlated with cirrhosis and certain tumor-related characteristics of initial HCC. The patterns of late recurrence suggest that postoperative surveillance after 2 years of surgery could be adjusted and more targeted. Regular postoperative surveillance improves the probability to receive curative treatments again, yielding to better outcomes for patients with late recurrence.
SESSION
Liver Oral Presentation 1
Room C 3/30/2018 9:00 AM - 9:50 AM