Early Versus Late Recurrence of Hepatocellular Carcinoma After Surgical Resection Based on Post-Recurrence Survival: an International Multi-Institutional Analysis
| Autor: | Tao Wei, Fabio Bagante, Thomas J. Hugh, Vincent Lam, Olivier Soubrane, Francesca Ratti, Timothy M. Pawlik, Xu-Feng Zhang, Sorin Alexandrescu, Yi Lv, Alfredo Guglielmi, Silvia Silva, Razvan Grigorie, Hugo Marques, George A. Poultsides, Luca Aldrighetti, Aklile Workneh, Guillaume Martel, Irinel Popescu |
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| Přispěvatelé: | Wei, T., Zhang, X. -F., Bagante, F., Ratti, F., Marques, H. P., Silva, S., Soubrane, O., Lam, V., Poultsides, G. A., Popescu, I., Grigorie, R., Alexandrescu, S., Martel, G., Workneh, A., Guglielmi, A., Hugh, T., Lv, Y., Aldrighetti, L., Pawlik, T. M. |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Curative resection
Surgical resection medicine.medical_specialty Carcinoma Hepatocellular Early Recurrence Hepatocellular carcinoma medicine.medical_treatment Late recurrence Gastroenterology Resection 03 medical and health sciences 0302 clinical medicine Early recurrence Risk Factors Internal medicine Late Recurrence medicine Hepatectomy Humans Post-recurrence survival Retrospective Studies business.industry Liver Neoplasms Retrospective cohort study medicine.disease Prognosis HCC CIR 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Surgery Neoplasm Recurrence Local business |
| Zdroj: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) Agência para a Sociedade do Conhecimento (UMIC)-FCT-Sociedade da Informação instacron:RCAAP |
| Popis: | Background: To define early versus late recurrence based on post-recurrence survival (PRS) among patients undergoing curative resection for hepatocellular carcinoma (HCC). Methods: Patients who underwent curative-intent resection for HCC between 2000 and 2017 were identified from an international multi-institutional database. The optimal cut-off time point to discriminate early versus late recurrence was determined relative to PRS. Results: Among 1004 patients, 443 (44.1%) patients experienced recurrence with a median recurrence-free survival time of 12 months. A cut-off time point of 8 months was defined as the optimal threshold based on sensitivity analyses relative to PRS for early (n = 165, 37.2%) versus late relapse (n = 278, 62.8%) (p = 0.008). Early recurrence was associated with worse PRS (median PRS, 27.0 vs. 43.0 months, p = 0.019), as well as overall survival (OS) (median OS, 32.0 versus 74.0 months, p < 0.001) versus late recurrence. In addition, patients who recurred early were more likely to recur at extra- ± intrahepatic (35.5% vs. 19.8%, p = 0.003) sites and were less likely to have the recurrence treated with curative intent (33.8% vs. 45.7%, p = 0.08). Patients undergoing curative re-treatment of late recurrence had a comparable OS with patients who had no recurrence (median OS, 139.0 vs. 140.0 months); patients with early recurrence had inferior OS after curative re-treatment versus patients with no recurrence (median OS, 69.0 vs. 140.0 months, p = 0.036), yet still better than patients who received palliative treatment for early recurrence (median OS, 69.0 vs. 21.0 months, p < 0.001). Conclusions: Eight months was identified as the cut-off value to differentiate early versus late recurrence. Curative-intent treatment for recurrent intrahepatic tumors was associated with reasonable long-term outcomes. info:eu-repo/semantics/publishedVersion |
| Databáze: | OpenAIRE |
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