Early extrahepatic recurrence as a pivotal factor for survival after hepatocellular carcinoma resection:A 15-year observational study  

作　　者：Jae Hyun Yoon Sung Kyu Choi Sung Bum Cho Hee Joon Kim Yang Seok Ko Chung Hwan Jun 

机构地区：[1]Department of Gastroenterology and Hepatology,Chonnam National University Hospital and College of Medicine,Gwangju 61469,South Korea [2]Department of Gastroenterology and Hepatology,Hwasun Chonnam National University Hospital and College of Medicine,Hwasun 58128,South Korea [3]Department of Surgery,Chonnam National University Hospital and College of Medicine,Gwangju 61469,South Korea [4]Department of Surgery,Hwasun Chonnam National University Hospital and College of Medicine,Hwasun 58128,South Korea [5]Department of Internal Medicine,Mokpo Hankook Hospital,Mokpo 58643,South Korea

出　　处：《World Journal of Gastroenterology》2022年第36期5351-5363,共13页世界胃肠病学杂志（英文版）

基　　金：Supported by Research Supporting Program of the Korean Association for the Study of the Liver and the Korean Liver Foundation,No. KASLKLF2019-06;Chonnam National University Hospital Biomedical Research Institute,No. BCRI121007

摘　　要：BACKGROUND Surgical resection is one of the most widely used modalities for the treatment of hepatocellular carcinoma(HCC).Early extrahepatic recurrence(EHR)of HCC after surgical resection is considered to be closely associated with poor prognosis.However,data regarding risk factors and survival outcomes of early EHR after surgical resection remain scarce.AIM To investigate the clinical features and risk factors of early EHR and elucidate its association with survival outcomes.METHODS From January 2004 to December 2019,we enrolled treatment-naïve patients who were≥18 years and underwent surgical resection for HCC in two tertiary academic centers.After excluding patients with tumor types other than HCC and/or ineligible data,this retrospective study finally included 779 patients.Surgical resection of HCC was performed according to the physicians’decisions and the EHR was diagnosed based on contrast-enhanced computed tomography or magnetic resonance imaging,and pathologic confirmation was performed in selected patients.Multivariate Cox regression analysis was performed to identify the variables associated with EHR.RESULTS Early EHR within 2 years after surgery was diagnosed in 9.5%of patients during a median followup period of 4.4 years.The recurrence-free survival period was 5.2 mo,and the median time to EHR was 8.8 mo in patients with early EHR.In 52.7%of patients with early EHR,EHR occurred as the first recurrence of HCC after surgical resection.On multivariate analysis,serum albumin<4.0 g/dL,serum alkaline phosphatase>100 U/L,surgical margin involvement,venous and/or lymphatic involvement,satellite nodules,tumor necrosis detected by pathology,tumor size≥7 cm,and macrovascular invasion were determined as risk factors associated with early EHR.After sub-categorizing the patients according to the number of risk factors,the rates of both EHR and survival showed a significant correlation with the risk of early EHR.Furthermore,multivariate analysis revealed that early EHR was associated with substantially wors

关 键 词：Early extrahepatic recurrence Hepatocellular carcinoma Prognosis Surgery SURVIVAL 

分 类 号：R735.7[医药卫生—肿瘤]