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Characteristics of Early Recurrence After Curative Liver Resection for Solitary Hepatocellular Carcinoma

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Early recurrence after liver resection of hepatocellular carcinoma (HCC) has a great effect on the survival of patients. The aims of this study were to identify risk factors for early recurrence and to clarify whether early recurrence is related to patient survival rate.

Methods

We identified a total of 1010 patients with HCC recurrence after hepatic resection between 2009 and 2014 in Samsung Medical Center and Seoul National University Hospital. Inclusion criteria were preoperative solitary tumor Child-Pugh class A and curative hepatectomy. Early recurrence was defined as HCC recurrence < 1 year after surgery.

Results

A total of 628 patients were included in this study: 302 with early recurrence and 326 with late recurrence. Multivariate analysis showed that HCC grade 3 or 4, tumor size > 3 cm, and microvascular invasion were closely associated with early recurrence after liver resection for solitary HCC. When HCC recurred, the early recurrence group had large tumor size, increased tumor numbers and AFP levels, and high incidence of diffuse intrahepatic recurrence compared with the late recurrence group. The overall survival curve for the early recurrence group was lower than that for the late recurrence group (P < 0.001). Multivariate analysis demonstrated early recurrence was closely associated with patient survival.

Conclusions

Patients with early recurrence had different characteristics compared to patients with late recurrence after hepatic resection in solitary HCC. Early detection of recurrence is necessary through active postoperative surveillance in hepatectomy patients with poor prognostic factors.

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Funding

This work was funded by the Korean Liver Cancer Association.

Author information

Author notes

  1. Sung-Mi Jung and Jong Man Kim contributed equally to this work.

Authors and Affiliations

  1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, South Korea

    Sung-Mi Jung, Jong Man Kim, Gyu-Seong Choi, Choon Hyuck David Kwon & Jae-Won Joh

  2. Division of HBP Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea

    Nam-Joon Yi, Kwang-Woong Lee & Kyung Suk Suh

Authors
  1. Sung-Mi Jung
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  2. Jong Man Kim
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  3. Gyu-Seong Choi
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  4. Choon Hyuck David Kwon
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  5. Nam-Joon Yi
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  6. Kwang-Woong Lee
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  7. Kyung Suk Suh
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  8. Jae-Won Joh
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Contributions

Sung Mi Jung: literature search, data analysis and interpretation and writing

Jong Man Kim: design, literature search, data acquisition, analysis, and interpretation and writing

Jae-Won Joh: design and data interpretation

Nam Joon Yi, Gyu-Seong Choi, Choon Hyuck David Kwon, Kwang-Woong Lee, and Kyung-Suk Suh: acquisition and analysis of data

Corresponding author

Correspondence to Jae-Won Joh.

Ethics declarations

This study was approved by the Samsung Medical Center Institutional Review Board (SMC 2013-05-013) and Seoul National University Hospital Institutional Review Board (H-1303-061-474).

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Jung, SM., Kim, J.M., Choi, GS. et al. Characteristics of Early Recurrence After Curative Liver Resection for Solitary Hepatocellular Carcinoma. J Gastrointest Surg 23, 304–311 (2019). https://doi.org/10.1007/s11605-018-3927-2

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  • DOI: https://doi.org/10.1007/s11605-018-3927-2

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