Journal
UPDATES IN SURGERY
Volume -, Issue -, Pages -Publisher
SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s13304-023-01652-y
Keywords
Hepatocellular carcinoma; Liver resection; Recurrence; Hazard function
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Predicting recurrence patterns of hepatocellular carcinoma (HCC) is important for surveillance strategies. This study used the hazard function to analyze recurrence hazard and peak recurrence time transitions in patients with HCC undergoing liver resection (LR). The results showed significant variations in recurrence hazard, patterns, and peak rates based on different risk factors of HCC recurrence.
Predicting recurrence patterns of hepatocellular carcinoma (HCC) can be helpful in developing surveillance strategies. This study aimed to use the hazard function to investigate recurrence hazard and peak recurrence time transitions in patients with HCC undergoing liver resection (LR). We enrolled 1204 patients with HCC undergoing LR between 2007 and 2018 at our institution. Recurrence hazard, patterns, and peak rates were analyzed. The overall recurrence hazard peaked at 7.2 months (peak hazard rate [pHR]: 0.0197), but varied markedly. In subgroups analysis based on recurrence risk factors, patients with a high radiographic tumor burden score (pHR: 0.0521), alpha-fetoprotein level >= 400 ng/ml (pHR: 0.0427), and pT3-4 (pHR: 0.0656) showed a pronounced peak within the first year after LR. Patients with cirrhosis showed a pronounced peak within three years after LR (pHR: 0.0248), whereas those with Barcelona Clinic Liver Cancer stage B (pHR: 0.0609) and poor tumor differentiation (pHR: 0.0451) showed multiple peaks during the 5-year follow-up period. In contrast, patients without these recurrence risk factors had a relatively flat hazard function curve. HCC recurrence hazard, patterns, and peak rates varied substantially depending on different risk factors of HCC recurrence.
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