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16-01-2024 | Hepatocellular Carcinoma | Original Article

Predictors for early recurrence beyond up-to-7 or distant metastasis after hepatocellular carcinoma resection: proposal for borderline resectable HCC

Authors: Norifumi Harimoto, Mariko Tsukagoshi, Takaomi Seki, Kouki Hoshino, Kei Hagiwara, Norihiro Ishii, Takamichi Igarashi, Kenichiro Araki, Koichiro Haruki, Toru Ikegami, Ken Shirabe

Published in: International Journal of Clinical Oncology | Issue 2/2024

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Abstract

Background

The recurrence rate after curative resection for hepatocellular carcinoma (HCC) reaches over 70% after 5 years and early recurrence (within 1 year) is now recognized as having a poor prognosis and has limited treatment options.

Methods

We retrospectively reviewed 184 consecutive patients who underwent curative hepatic resection for HCC. Severe early recurrence was defined as multiple (beyond up-to-7) liver recurrence or distant metastasis after hepatic resection within 1 year. We divided the participants into two groups according to severe early recurrence and analyzed clinicopathological and long-term outcomes.

Results

Among the patients with multiple or distant metastasis (n = 59), 49 patients (83%) had recurrence within 1 year. Overall survival (OS) and recurrence-free survival (RFS) were significantly worse in the severe early recurrence group than in the others group. Logistic regression analysis revealed that severe early recurrence was significantly associated with macroscopic vascular invasion (MVI), tumor burden score (TBS) > 4.70, and ALBI grade 2. In patients with scores of 2 and 3 (the sum of the three factors), OS and RFS rates were significantly poorer than those of patients with scores of 0 or 1. Positive predictive value and negative predictive value for severe early recurrence was 68.4% and 84.2%, respectively. Furthermore, a validation study demonstrated that cases with these factors were at high risk of severe early recurrence and had poor prognosis.

Conclusions

In this retrospective analysis, MVI, TBS, and ALBI could predict severe early recurrence after hepatic resection for HCC, and patients with these risk factors had a poor prognosis.
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Metadata
Title
Predictors for early recurrence beyond up-to-7 or distant metastasis after hepatocellular carcinoma resection: proposal for borderline resectable HCC
Authors
Norifumi Harimoto
Mariko Tsukagoshi
Takaomi Seki
Kouki Hoshino
Kei Hagiwara
Norihiro Ishii
Takamichi Igarashi
Kenichiro Araki
Koichiro Haruki
Toru Ikegami
Ken Shirabe
Publication date
16-01-2024
Publisher
Springer Nature Singapore
Published in
International Journal of Clinical Oncology / Issue 2/2024
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-023-02434-7

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