Abstract
Background
Hepatectomy is currently recommended as the most reliable treatment for hepatocellular carcinoma. However, the association between the choice of treatment for recurrence and the timing of recurrence remains controversial.
Methods
Three-hundred thirty-nine patients who underwent hepatectomy were retrospectively analyzed using a propensity score matching analysis for the risk factors and outcomes for early recurrences within 6 months. The remnant liver volumes and laboratory data were measured postoperatively using multidetector computed tomography on days 7 and months 1, 2, and 5 after surgery. The Student’s t test and chi-square test, the likelihood-ratio test, Fisher’s exact test, Mann–Whitney U test, or Wilcoxon signed-rank test were used in the statistical analyses.
Results
Early recurrence developed in 41/312 patients (13.1%). Vascular invasion and non-curative resection were independent risk factors for the occurrence of early recurrence (P < 0.001 and < 0.001, respectively). Patients with early recurrence had a poorer prognosis than patients who developed later recurrences (P < 0.001). Patients who underwent surgery or other local treatments had better outcomes (P < 0.001). The changes in remnant liver volumes and laboratory data after postoperative month 2 were not significantly different between the two groups.
Conclusion
Patients with early recurrence within 6 months had a poorer prognosis than patients who developed a later recurrence. However, patients who underwent repeat hepatectomy for recurrences had a better prognosis than did those who underwent other treatments, with good prospects for long-term survival.
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All patients provided written informed consent to participate and the study design was approved by the Ethics Committee on Clinical Investigation of Osaka Medical College Hospital (approval no. 2001 and 2059).
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YI conceived the study concept and design, was involved with patient care, and drafted the manuscript. YS, MO, KK, TK, KF, KM, YM, TM, KY, HO, YI, RT, MS, YT, TT, SM, MY, AA, YS, MI, SF, YN, MT, MG, FK, KH, and KU were involved with creation of the study concept and design, patient care, and drafting of the manuscript. All authors have read and approved the final version of the manuscript.
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Inoue, Y., Suzuki, Y., Ota, M. et al. The Management of Recurrence of Hepatocellular Carcinoma Occurring Within 6 Months After Hepatic Resection: A Comparative Study Using a Propensity Score Matching Analysis. J Gastrointest Canc 53, 272–281 (2022). https://doi.org/10.1007/s12029-021-00585-2
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DOI: https://doi.org/10.1007/s12029-021-00585-2