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Early Versus Late Recurrence of Hepatocellular Carcinoma After Surgical Resection Based on Post-Recurrence Survival: an International Multi-Institutional Analysis

2021Journal article Open access
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dc.contributor.authorWei, T
dc.contributor.authorZhang, XF
dc.contributor.authorBagante, F
dc.contributor.authorRatti, F
dc.contributor.authorPinto Marques, H
dc.contributor.authorSilva, S
dc.contributor.authorSoubrane, O
dc.contributor.authorLam, V
dc.contributor.authorPoultsides, G
dc.contributor.authorPopescu, I
dc.contributor.authorGrigorie, R
dc.contributor.authorAlexandrescu, S
dc.contributor.authorMartel, G
dc.contributor.authorWorkneh, A
dc.contributor.authorGuglielmi, A
dc.contributor.authorHugh, T
dc.contributor.authorLv, Y
dc.contributor.authorAldrighetti, L
dc.contributor.authorPawlik, T
dc.date.accessioned2021-06-15T10:48:22Z
dc.date.available2021-06-15T10:48:22Z
dc.date.issued2021
dc.description.abstractBackground: To define early versus late recurrence based on post-recurrence survival (PRS) among patients undergoing curative resection for hepatocellular carcinoma (HCC). Methods: Patients who underwent curative-intent resection for HCC between 2000 and 2017 were identified from an international multi-institutional database. The optimal cut-off time point to discriminate early versus late recurrence was determined relative to PRS. Results: Among 1004 patients, 443 (44.1%) patients experienced recurrence with a median recurrence-free survival time of 12 months. A cut-off time point of 8 months was defined as the optimal threshold based on sensitivity analyses relative to PRS for early (n = 165, 37.2%) versus late relapse (n = 278, 62.8%) (p = 0.008). Early recurrence was associated with worse PRS (median PRS, 27.0 vs. 43.0 months, p = 0.019), as well as overall survival (OS) (median OS, 32.0 versus 74.0 months, p < 0.001) versus late recurrence. In addition, patients who recurred early were more likely to recur at extra- ± intrahepatic (35.5% vs. 19.8%, p = 0.003) sites and were less likely to have the recurrence treated with curative intent (33.8% vs. 45.7%, p = 0.08). Patients undergoing curative re-treatment of late recurrence had a comparable OS with patients who had no recurrence (median OS, 139.0 vs. 140.0 months); patients with early recurrence had inferior OS after curative re-treatment versus patients with no recurrence (median OS, 69.0 vs. 140.0 months, p = 0.036), yet still better than patients who received palliative treatment for early recurrence (median OS, 69.0 vs. 21.0 months, p < 0.001). Conclusions: Eight months was identified as the cut-off value to differentiate early versus late recurrence. Curative-intent treatment for recurrent intrahepatic tumors was associated with reasonable long-term outcomes.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Gastrointest Surg. 2021 Jan;25(1):125-133.pt_PT
dc.identifier.doi10.1007/s11605-020-04553-2pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3729
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerpt_PT
dc.subjectHepatectomypt_PT
dc.subjectHumanspt_PT
dc.subjectNeoplasm Recurrence, Localpt_PT
dc.subjectPrognosispt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectRisk Factorspt_PT
dc.subjectCarcinoma, Hepatocellularpt_PT
dc.subjectLiver Neoplasmspt_PT
dc.subjectHCC CIRpt_PT
dc.titleEarly Versus Late Recurrence of Hepatocellular Carcinoma After Surgical Resection Based on Post-Recurrence Survival: an International Multi-Institutional Analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage133pt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPage125pt_PT
oaire.citation.titleJournal of Gastrointestinal Surgerypt_PT
oaire.citation.volume25pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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