Detailed Abstract
[E-poster - Liver (Liver Disease/Surgery)]
[EP 028] Risk factors and long-term prognosis of BCLC stage 0/a hepatocellular carcinoma for beyond milan recurrence after hepatectomy: A multicenter observational study
Zi-Han FENG1 , Ming-Da WANG2 , Li-Yang SUN3 , Xiao XU1 , Qing-Yu KONG1 , Zi-Xiang CHEN4 , Yong-Yi ZENG5 , Timothy M. PAWLIK6 , Wan Yee LAU7 , Feng SHEN2 , Zhong CHEN1 , Tian YANG*2
1 Hepatobiliary Surgery, Affiliated Hospital Of Nantong University, CHINA
2 Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), CHINA
3 Hepatobiliary Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital Of Hangzhou Medical College, CHINA
4 Hepatobiliary Surgery, The First Affiliated Hospital Of Anhui Medical University, CHINA
5 Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital, Fujian Medical University, CHINA
6 Surgery, Ohio State University, Wexner Medical Center, UNITED STATES OF AMERICA
7 Faculty Of Medicine, The Chinese University Of Hong Kong, Shatin, New Territories, CHINA
s
Background : Data on recurrence are important to inform surveillance and improve long-term surgical outcomes for patients with hepatocellular carcinoma (HCC). We sought to identify risk factors and long-term prognosis among patients who experienced beyond-Milan recurrence (BMR) after hepatectomy for early-stage HCC.
Methods : Patients who underwent hepatectomy for BCLC stage 0/A HCC were identified from a multi-institutional database. Predictors of BMR and risk factors associated with post-recurrence survival (PRS) among patients with BMR were assessed using univariate and multivariate Cox-regression analyses.
Results : Among 753 patients, 138 (18.3%) developed BMR at a median follow-up of 51.8 months. Regular surveillance (interval follow-up ≤3 months within 1 year and ≤6 months in subsequent years after surgery) was not carried out for 53 (38.4%) patients who developed BMR. On multivariate analysis, increased risk of BMR was independently associated with preoperative alpha-fetoprotein level >400 ng/mL, tumor size >5.0 cm, multifocal disease, microvascular invasion, and no/irregular recurrence surveillance. Median PRS among patients with BMR was only 8.4 months (95%CI:7.0-9.8 months). Among patients who developed BMR, Child-Pugh grade B/C, early recurrence within 1 year after surgery, macrovascular invasion/distant metastasis, and non-curative treatment of recurrence were independent risk factors associated with worse PRS. c
Conclusions : Nearly 1 in 5 patients developed BMR following hepatectomy for early-stage HCC. Patients with BMR had a median survival of less than 1 year after diagnosis of the recurrence. Regular surveillance is an important and actionable measure to decrease BMR and, in turn, improve long-term survival among patients treated with hepatectomy for HCC.
Methods : Patients who underwent hepatectomy for BCLC stage 0/A HCC were identified from a multi-institutional database. Predictors of BMR and risk factors associated with post-recurrence survival (PRS) among patients with BMR were assessed using univariate and multivariate Cox-regression analyses.
Results : Among 753 patients, 138 (18.3%) developed BMR at a median follow-up of 51.8 months. Regular surveillance (interval follow-up ≤3 months within 1 year and ≤6 months in subsequent years after surgery) was not carried out for 53 (38.4%) patients who developed BMR. On multivariate analysis, increased risk of BMR was independently associated with preoperative alpha-fetoprotein level >400 ng/mL, tumor size >5.0 cm, multifocal disease, microvascular invasion, and no/irregular recurrence surveillance. Median PRS among patients with BMR was only 8.4 months (95%CI:7.0-9.8 months). Among patients who developed BMR, Child-Pugh grade B/C, early recurrence within 1 year after surgery, macrovascular invasion/distant metastasis, and non-curative treatment of recurrence were independent risk factors associated with worse PRS. c
Conclusions : Nearly 1 in 5 patients developed BMR following hepatectomy for early-stage HCC. Patients with BMR had a median survival of less than 1 year after diagnosis of the recurrence. Regular surveillance is an important and actionable measure to decrease BMR and, in turn, improve long-term survival among patients treated with hepatectomy for HCC.
SESSION
E-poster
E-Session 03/03 ~ 03/05 ALL DAY