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Risk Factors Affecting the Recurrence-Free Survival of Hepatocellular Carcinoma After Hepatectomy: a Meta-analysis

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Abstract

This study aims to investigate the risk factors affecting the recurrence-free survival of hepatocellular carcinoma after hepatectomy and to provide reference for improving the prognosis of patients with liver cancer. Relevant literatures on risk factors affecting the recurrence-free survival of hepatocellular carcinoma after hepatectomy were searched and analyzed in MEDLINE, Embase, PubMed, the Cochrane Library, and CBMDisc databases, and meta-analysis of the included literatures was performed using Revman 5.3. Thirty-two literatures were included, and the multivariate analysis results in these literatures were meta-analyzed. The results showed that cirrhosis (HR = 1.33, 95% CI (1.19–1.49)), AFP > 400 ng/dl (HR = 1.30, 95% CI (1.18–1.43)), blood transfusion (HR = 1.32, 95% CI (1.16–1.51)), tumor diameter > 5 cm (HR = 1.44, 95% CI, 1.36–1.53)), multiple tumors (HR = 1.56, 95% CI (1.40–1.73)), satellite nodules (HR = 1.84, 95% CI (1.62–2.10)), vascular invasion (HR = 1.52, 95% CI, 1.37–1.69)), MVI (HR = 1.49, 95% CI (1.37–1.61)), low differentiation (HR = 1.27, 95% CI (1.07–1.50)), TNM staging (III/IV, HR = 2.16, 95% CI (1.59–2.93)), and BCLC staging (B/C, HR = 1.98, 95% CI (1.34–2.92)) were statistically significant risk factors affecting the recurrence-free survival of hepatocellular carcinoma after hepatectomy. But AST > 40 U/L was not a statistically significant risk factor for the recurrence-free survival (P > 0.05). Results of sensitivity analysis and publication bias assessment showed that there was no publication bias in the included literatures, and the results were relatively reliable. Cirrhosis, AFP > 400 ng/dl, perioperative blood transfusion, tumor diameter > 5 cm, multiple tumors, satellite nodules, vascular invasion, MVI, low differentiation, and advanced stage of TNM and BCLC stage are the risk factors affecting the recurrence-free survival of hepatocellular carcinoma after hepatectomy.

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References

  1. Wassmer CH, Moeckli B, Berney T et al (2021) Shorter survival after liver pedicle clamping in patients undergoing liver resection for hepatocellular carcinoma revealed by a systematic review and meta-analysis. Cancers (Basel) 13(4):637

    Article  Google Scholar 

  2. Zhang X, Li J, Shen F, Lau WY (2018) Significance of presence of microvascular invasion in specimens obtained after surgical treatment of hepatocellular carcinoma. J Gastroenterol Hepatol 33(2):347–354

    Article  Google Scholar 

  3. Wu Y, Tu C, Shao C (2021) Inflammatory indexes in preoperative blood routine to predict early recurrence of hepatocellular carcinoma after curative hepatectomy. BMC Surg 21(1):178

    Article  CAS  Google Scholar 

  4. Qin L, Li C, Xie F et al (2021) Combination of albumin-bilirubin grade and clinically significant portal hypertension predicts the prognosis of patients with hepatocellular carcinoma after liver resection. Biosci Trends 15(1):41–49

    Article  CAS  Google Scholar 

  5. Gruttadauria S, Barbera F, Conaldi PG et al (2021) Clinical and molecular-based approach in the evaluation of hepatocellular carcinoma recurrence after radical liver resection. Cancers (Basel) 13(3):518

    Article  CAS  Google Scholar 

  6. Chen KY, Huang YH, Teo WH et al (2021) Loss of Tid1/DNAJA3 co-chaperone promotes progression and recurrence of hepatocellular carcinoma after surgical resection: a novel model to stratify risk of recurrence. Cancers (Basel) 13(1):138

    Article  Google Scholar 

  7. Zhang W, Liu F, Huang J et al (2020) Effect of menopausal status on the survival and recurrence of sex-classified hepatocellular carcinoma after liver resection: a case-matched study with propensity score matching. Aging (Albany NY) 12(24):25895–25915

    Article  Google Scholar 

  8. Yang J, Bao Y, Chen W et al (2020) Nomogram based on systemic immune inflammation index and prognostic nutrition index predicts recurrence of hepatocellular carcinoma after surgery. Front Oncol 10:551668

    Article  Google Scholar 

  9. Zhang CC, Zhang CW, Xing H et al (2020) Preoperative inversed albumin-to-globulin ratio predicts worse oncologic prognosis following curative hepatectomy for hepatocellular carcinoma. Cancer Manag Res 12:9929–9939

    Article  CAS  Google Scholar 

  10. Wang T, Yang X, Tang H et al (2020) Integrated nomograms to predict overall survival and recurrence-free survival in patients with combined hepatocellular cholangiocarcinoma (cHCC) after liver resection. Aging (Albany NY) 12(15):15334–15358

    Article  CAS  Google Scholar 

  11. Cho WR, Hung CH, Chen CH et al (2020) Ability of the post-operative ALBI grade to predict the outcomes of hepatocellular carcinoma after curative surgery. Sci Rep 10(1):7290

    Article  CAS  Google Scholar 

  12. Wang J, Huang A, Wang YP et al (2020) Circulating tumor DNA correlates with microvascular invasion and predicts tumor recurrence of hepatocellular carcinoma. Ann Transl Med 8(5):237

    Article  CAS  Google Scholar 

  13. Wang L, Li Q, Zhang J et al (2019) A novel prognostic scoring model based on albumin and γ-glutamyltransferase for hepatocellular carcinoma prognosis. Cancer Manag Res 11:10685–10694

    Article  CAS  Google Scholar 

  14. Tsai MY, Yen YH, Huang PY et al (2019) The pre- and postoperative FIB-4 indexes are good predictors to the outcomes of HBV-related HCC patients after resection. Gastroenterol Res Pract 2019:8945798

    Article  Google Scholar 

  15. Uchinaka EI, Amisaki M, Yagyu T et al (2019) Prognostic significance of pre-surgical combined platelet count and neutrophil-lymphocyte ratio for patients with hepatocellular carcinoma. In Vivo 33(6):2241–2248

  16. Young SH, Chau GY, Lee IC et al (2020) Aspirin is associated with low recurrent risk in hepatitis B virus-related hepatocellular carcinoma patients after curative resection. J Formos Med Assoc 119(1Pt2):218–229

    Article  CAS  Google Scholar 

  17. Lai MW, Chu YD, Lin CL et al (2019) Is there a sex difference in postoperative prognosis of hepatocellular carcinoma? BMC Cancer 19(1):250

    Article  Google Scholar 

  18. Imai K, Takai K, Hanai T et al (2019) Homeostatic model assessment of insulin resistance for predicting the recurrence of hepatocellular carcinoma after curative treatment. Int J Mol Sci 20(3):605

    Article  CAS  Google Scholar 

  19. Zhang J, Luo Y, Li C et al (2019) The combination of the preoperative albumin-bilirubin grade and the fibrosis-4 index predicts the prognosis of patients with hepatocellular carcinoma after liver resection. Biosci Trends 13(4):351–357

    Article  CAS  Google Scholar 

  20. Li JD, Xu XF, Han J et al (2019) Preoperative prealbumin level as an independent predictor of long-term prognosis after liver resection for hepatocellular carcinoma: a multi-institutional study. HPB (Oxford) 21(2):157–166

    Article  Google Scholar 

  21. Rungsakulkij N, Suragul W, Mingphruedhi S et al (2018) Prognostic factors in patients with HBV-related hepatocellular carcinoma following hepatic resection. Infect Agent Cancer 13:20

    Article  Google Scholar 

  22. Hamaguchi Y, Kaido T, Okumura S et al (2019) Preoperative visceral adiposity and muscularity predict poor outcomes after hepatectomy for hepatocellular carcinoma. Liver Cancer 8(2):92–109

    Article  Google Scholar 

  23. Qu L, Chen Y, Zhang H et al (2017) Pre-S deletions of hepatitis B virus predict recurrence of hepatocellular carcinoma after curative resection. Medicine (Baltimore) 96(43):e8311

    Article  CAS  Google Scholar 

  24. Tian L, Yu Q, Gao XH et al (2017) A new use for an old index: preoperative high-density lipoprotein predicts recurrence in patients with hepatocellular carcinoma after curative resections. Lipids Health Dis 16(1):123

    Article  Google Scholar 

  25. Li Z, Zhao X, Jiang P et al (2016) HBV is a risk factor for poor patient prognosis after curative resection of hepatocellular carcinoma: a retrospective case-control study. Medicine (Baltimore) 95(31):e4224

    Article  Google Scholar 

  26. Lee YL, Li WC, Tsai TH et al (2016) Body mass index and cholesterol level predict surgical outcome in patients with hepatocellular carcinoma in Taiwan - a cohort study. Oncotarget 7(16):22948–22959

    Article  Google Scholar 

  27. Hung IF, Wong DK, Poon RT et al (2016) Risk factors and post-resection independent predictive score for the recurrence of hepatitis B-related hepatocellular carcinoma. PLoS One 11(2):e0148493

    Article  Google Scholar 

  28. Hamaguchi Y, Kaido T, Okumura S et al (2015) Preoperative intramuscular adipose tissue content is a novel prognostic predictor after hepatectomy for hepatocellular carcinoma. J Hepatobiliary Pancreat Sci 22(6):475–485

    Article  Google Scholar 

  29. Sonohara F, Nomoto S, Inokawa Y et al (2015) Serosal invasion strongly associated with recurrence after curative hepatic resection of hepatocellular carcinoma: a retrospective study of 214 consecutive cases. Medicine (Baltimore) 94(9):e602

    Article  Google Scholar 

  30. Han JH, Kim DG, Na GH et al (2014) Evaluation of prognostic factors on recurrence after curative resections for hepatocellular carcinoma. World J Gastroenterol 20(45):17132–17140

    Article  Google Scholar 

  31. Zhang XF, Wei T, Liu XM et al (2014) Impact of cigarette smoking on outcome of hepatocellular carcinoma after surgery in patients with hepatitis B. PLoS One 9(1):e85077

    Article  Google Scholar 

  32. Ma WJ, Wang HY, Teng LS (2013) Correlation analysis of preoperative serum alpha-fetoprotein (AFP) level and prognosis of hepatocellular carcinoma (HCC) after hepatectomy. World J Surg Oncol 11:212

    Article  Google Scholar 

  33. Shindoh J, Hasegawa K, Inoue Y et al (2013) Risk factors of post-operative recurrence and adequate surgical approach to improve long-term outcomes of hepatocellular carcinoma. HPB (Oxford) 15(1):31–39

    Article  Google Scholar 

  34. Cheung YS, Chan HL, Wong J et al (2008) Elevated perioperative transaminase level predicts intrahepatic recurrence in hepatitis B-related hepatocellular carcinoma after curative hepatectomy. Asian J Surg 31(2):41–49

    Article  Google Scholar 

  35. Yang T, Liu K, Liu CF et al (2019) Impact of postoperative infective complications on long-term survival after liver resection for hepatocellular carcinoma. Br J Surg 106(9):1228–1236

    Article  CAS  Google Scholar 

  36. Sugita S, Sasaki A, Iwaki K et al (2008) Prognosis and postoperative lymphocyte count in patients with hepatocellular carcinoma who received intraoperative allogenic blood transfusion: a retrospective study. Eur J Surg Oncol 34(3):339–345

    Article  CAS  Google Scholar 

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Author notes

  1. Jisen Cao and Ruiqiang Zhang contributed equally to this work.

Authors and Affiliations

  1. Department of Hepatobiliary Surgery, The Third Central Hospital of Tianjin, Tianjin, China

    Jisen Cao, Ye Zhang & Yijun Wang

  2. Department of Orthopedics, General Hospital of Tianjin Medical University, Tianjin, China

    Ruiqiang Zhang

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  1. Jisen Cao
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  2. Ruiqiang Zhang
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  3. Ye Zhang
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Correspondence to Ye Zhang.

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Cao, J., Zhang, R., Zhang, Y. et al. Risk Factors Affecting the Recurrence-Free Survival of Hepatocellular Carcinoma After Hepatectomy: a Meta-analysis. Indian J Surg 84 (Suppl 2), 373–383 (2022). https://doi.org/10.1007/s12262-022-03287-6

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  • DOI: https://doi.org/10.1007/s12262-022-03287-6

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