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Disease-Free Interval and Tumor Stage Complementarily Predict the Biological Behavior of Recurrent Hepatocellular Carcinoma

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Currently used treatment algorithms were originally established based on the clinical outcomes of the initial treatment for primary hepatocellular carcinoma (HCC), and no strong evidence exists yet to suggest if these algorithms could also be applicable to patients with recurrent HCC after surgery. As such, this study sought to explore an optimal risk stratification method for cases of recurrent HCC for better clinical management.

Methods

Among the 1616 patients who underwent curative resection for HCC, the clinical features and survival outcomes of 983 patients who developed recurrence were examined in detail.

Results

Multivariate analysis confirmed that both the disease-free interval (DFI) from the previous surgery and tumor stage at recurrence were significant prognostic factors. However, the prognostic impact of DFI seemed different according to the tumor stages at recurrence. While curative-intent treatment showed strong influence on survival [hazard ratio (HR), 0.61; P < 0.001] regardless of the DFI in patients with stage 0 or stage A disease at recurrence, early recurrence (< 6 months) was a poor prognostic marker in patients with stage B disease. The prognosis of patients with stage C disease was exclusively influenced by the tumor distribution or choice of treatment than by the DFI.

Conclusions

The DFI complementarily predicts the oncological behavior of recurrent HCC, with its predictive value differing depending on the tumor stage at recurrence. These factors should be considered for selection of the optimal treatment in patients with recurrent HCC after curative-intent surgery.

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Authors and Affiliations

  1. Hepatobiliary-Pancreatic Surgery Division, Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan

    Junichi Shindoh MD, PhD, Masaru Matsumura MD, PhD, Masahiro Kobayashi MD, Miho Akabane MD, Satoshi Okubo MD, PhD & Masaji Hashimoto MD, PhD

  2. Okinaka Memorial Institute for Medical Disease, Tokyo, Japan

    Junichi Shindoh MD, PhD

Authors
  1. Junichi Shindoh MD, PhD
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  2. Masaru Matsumura MD, PhD
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  3. Masahiro Kobayashi MD
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  4. Miho Akabane MD
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  5. Satoshi Okubo MD, PhD
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  6. Masaji Hashimoto MD, PhD
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Corresponding author

Correspondence to Junichi Shindoh MD, PhD.

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The authors have no conflicts of interest to disclose. This study was supported by a grant from Okinaka Memorial Institute for Medical Disease.

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Shindoh, J., Matsumura, M., Kobayashi, M. et al. Disease-Free Interval and Tumor Stage Complementarily Predict the Biological Behavior of Recurrent Hepatocellular Carcinoma. Ann Surg Oncol 30, 3402–3410 (2023). https://doi.org/10.1245/s10434-023-13228-6

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  • DOI: https://doi.org/10.1245/s10434-023-13228-6

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