nach oben

Journal of Cancer Research and Clinical Oncology

Erschienen in:

26.08.2023 | Research

Repeat hepatectomy versus percutaneous ablation for recurrent hepatocellular carcinoma: emphasis on the impact of early or late recurrence

verfasst von: Chenwei Wang, Kai Li, Zhenkun Huang, Yichuan Yuan, Wei He, Yun Zheng, Ruhai Zou, Binkui Li, Yunfei Yuan, Jiliang Qiu

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 16/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Recurrent hepatocellular carcinoma (rHCC) patients with early recurrence usually suffer a poorer prognosis than those with late recurrence. We aimed to compare the treatment efficacy of repeat hepatectomy (RH) and percutaneous ablation (PA) in early-stage rHCC patients with early or late recurrence.

Methods

This retrospective study enrolled 268 patients diagnosed with early-stage rHCC who received RH and PA. Overall survival (OS) and repeat recurrence-free survival (rRFS) were compared using log-rank analysis. Propensity score matching (PSM) was used to reduce the confounding bias.

Results

Among the 268 patients with early-stage rHCC, 79 underwent RH and 189 underwent PA. Early (n = 174) and late (n = 94) recurrence was defined as recurrence within and after 2 years following initial hepatectomy, respectively. For patients with early recurrence, RH and PA provided similar 5-year OS (71.5% versus 74.4%, P = 0.87) and rRFS rates (24.7% versus 24.9%, P = 0.73). For patients with late recurrence, RH resulted in comparable 5-year OS (73.1% versus 86.1%, P = 0.62) and rRFS rates (36.6% versus 27.8%, P = 0.34) as PA. After PSM, RH continued to share similar 5-year OS and rRFS rates with PA in patients with early recurrence, and comparable efficacy of RH and PA was also observed in patients with late recurrence.

Conclusion

RH can offer comparable OS and rRFS rates as PA for early-stage rHCC patients, regardless of whether they experience early or late recurrence. Therefore, both RH and PA are feasible treatment options for early-stage rHCC patients.

Nur mit Berechtigung zugänglich

Austin PC (2011) Optimal caliper widths for propensity-score matching when estimating differences in means and differences in proportions in observational studies. Pharm Stat 10:150–161. https://doi.org/10.1002/pst.433CrossRefPubMed

Brookhart MA, Schneeweiss S, Rothman KJ, Glynn RJ, Avorn J, Sturmer T (2006) Variable selection for propensity score models. Am J Epidemiol 163:1149–1156. https://doi.org/10.1093/aje/kwj149CrossRefPubMed

Chan AC, Poon RT, Cheung TT, Chok KS, Chan SC, Fan ST, Lo CM (2012) Survival analysis of re-resection versus radiofrequency ablation for intrahepatic recurrence after hepatectomy for hepatocellular carcinoma. World J Surg 36:151–156. https://doi.org/10.1007/s00268-011-1323-0CrossRefPubMed

Chan AWH et al (2018) Development of pre and post-operative models to predict early recurrence of hepatocellular carcinoma after surgical resection. J Hepatol 69:1284–1293. https://doi.org/10.1016/j.jhep.2018.08.027CrossRefPubMed

Cheng Z et al (2015) Risk factors and management for early and late intrahepatic recurrence of solitary hepatocellular carcinoma after curative resection. HPB (oxford) 17:422–427. https://doi.org/10.1111/hpb.12367CrossRefPubMed

Choi G-H, Kim D-H, Kang C-M, Kim K-S, Choi J-S, Lee W-J, Kim B-R (2007) Prognostic factors and optimal treatment strategy for intrahepatic nodular recurrence after curative resection of hepatocellular carcinoma. Ann Surg Oncol 15:618–629. https://doi.org/10.1245/s10434-007-9671-6CrossRefPubMed

Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 240:205–213. https://doi.org/10.1097/01.sla.0000133083.54934.aeCrossRefPubMedPubMedCentral

El-Domiaty N et al (2021) Early versus late hepatocellular carcinoma recurrence after transplantation: predictive factors patterns, and long-term outcome. Transplantation 105:1778–1790. https://doi.org/10.1097/TP.0000000000003434CrossRefPubMed

Erridge S et al (2017) Meta-analysis of determinants of survival following treatment of recurrent hepatocellular carcinoma. Br J Surg 104:1433–1442. https://doi.org/10.1002/bjs.10597CrossRefPubMed

Forner A, Reig M, Bruix J (2018) Hepatocellular Carcinoma. The Lancet 391:1301–1314. https://doi.org/10.1016/s0140-6736(18)30010-2CrossRef

Galle PR et al (2018) EASL clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 69:182–236. https://doi.org/10.1016/j.jhep.2018.03.019CrossRef

Gavriilidis P, Askari A, Azoulay D (2017) Survival following redo hepatectomy vs radiofrequency ablation for recurrent hepatocellular carcinoma: a systematic review and meta-analysis. HPB (oxford) 19:3–9. https://doi.org/10.1016/j.hpb.2016.10.003CrossRefPubMed

He W et al (2016) Resection vs. ablation for alpha-fetoprotein positive hepatocellular carcinoma within the Milan criteria: a propensity score analysis. Liver Int 36:1677–1687. https://doi.org/10.1111/liv.13166/suppinfoCrossRefPubMed

He W et al (2018) Nomogram to predict survival of patients with recurrence of hepatocellular carcinoma after surgery. Clin Gastroenterol Hepatol 16:756-764 e710. https://doi.org/10.1016/j.cgh.2017.12.002CrossRefPubMed

Hong SK et al (2022) Different risk factors for early and late recurrence after curative resection of hepatocellular carcinoma. World J Surg 46:197–206. https://doi.org/10.1007/s00268-021-06308-9CrossRefPubMed

Huang Z-y et al (2012) Long-term outcomes of repeat hepatic resection in patients with recurrent hepatocellular carcinoma and analysis of recurrent types and their prognosis: a single-center experience in China. Ann Surg Oncol 19:2515–2525. https://doi.org/10.1245/s10434-012-2269-7CrossRefPubMed

Imamura H et al (2003) Risk factors contributing to early and late phase intrahepatic recurrence of hepatocellular carcinoma after hepatectomy. J Hepatol 38:200–207. https://doi.org/10.1016/s0168-8278(02)00360-4CrossRefPubMed

Johnson SR, Tomlinson GA, Hawker GA, Granton JT, Feldman BM (2018) Propensity score methods for bias reduction in observational studies of treatment effect. Rheum Dis Clin North Am 44:203–213. https://doi.org/10.1016/j.rdc.2018.01.002CrossRefPubMed

Liang HH, Chen MS, Peng ZW, Zhang YJ, Zhang YQ, Li JQ, Lau WY (2008) Percutaneous radiofrequency ablation versus repeat hepatectomy for recurrent hepatocellular carcinoma: a retrospective study. Ann Surg Oncol 15:3484–3493. https://doi.org/10.1245/s10434-008-0076-yCrossRefPubMed

Lim K-C et al (2011) Microvascular invasion is a better predictor of tumor recurrence and overall survival following surgical resection for hepatocellular carcinoma compared to the milan criteria. Ann Surg 254:108–113. https://doi.org/10.1097/SLA.0b013e31821ad884CrossRefPubMed

Liu W et al (2019) Microwave ablation versus resection for hepatocellular carcinoma within the Milan criteria: a propensity-score analysis. Ther Adv Med Oncol 11:1758835919874652. https://doi.org/10.1177/1758835919874652CrossRefPubMed

Marrero JA et al (2018) Diagnosis, staging, and management of hepatocellular carcinoma: 2018 practice guidance by the American association for the study of liver diseases. Hepatology (Baltimore, Md). 68:723–750. https://doi.org/10.1002/hep.29913CrossRefPubMed

Meniconi RL, Komatsu S, Perdigao F, Boelle PY, Soubrane O, Scatton O (2015) Recurrent hepatocellular carcinoma: a Western strategy that emphasizes the impact of pathologic profile of the first resection. Surgery 157:454–462. https://doi.org/10.1016/j.surg.2014.10.011CrossRefPubMed

Portolani N, Coniglio A, Ghidoni S, Giovanelli M, Benetti A, Tiberio GA, Giulini SM (2006) Early and late recurrence after liver resection for hepatocellular carcinoma: prognostic and therapeutic implications. Ann Surg 243:229–235. https://doi.org/10.1097/01.sla.0000197706.21803.a1CrossRefPubMedPubMedCentral

R Core Team (2016) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria

Riccardo N et al (2023) Predictors of early and late hepatocellular carcinoma recurrence world. J Gastroenterol 29:1243–1260

Roayaie S et al (2009) A system of classifying microvascular invasion to predict outcome after resection in patients with hepatocellular carcinoma. Gastroenterology 137:850–855. https://doi.org/10.1053/j.gastro.2009.06.003CrossRefPubMed

Song K et al (2015) Repeated hepatic resection versus radiofrequency ablation for recurrent hepatocellular carcinoma after hepatic resection: a propensity score matching study. Radiology 275:599–608CrossRefPubMed

Tabrizian P, Jibara G, Shrager B, Schwartz M, Roayaie S (2015) Recurrence of hepatocellular cancer after resection. Ann Surg 261:947–955. https://doi.org/10.1097/sla.0000000000000710CrossRefPubMed

Villanueva A, Longo DL (2019) Hepatocellular carcinoma. N Engl J Med 380:1450–1462. https://doi.org/10.1056/NEJMra1713263CrossRefPubMed

Vogel A, Meyer T, Sapisochin G, Salem R, Saborowski A (2022) Hepatocellular carcinoma. Lancet 400:1345–1362. https://doi.org/10.1016/S0140-6736(22)01200-4CrossRefPubMed

Wang K et al (2015) Early intrahepatic recurrence of hepatocellular carcinoma after hepatectomy treated with re-hepatectomy, ablation or chemoembolization: a prospective cohort study. Eur J Surg Oncol. 41:236–242. https://doi.org/10.1016/j.ejso.2014.11.002CrossRefPubMed

Wang C et al (2019) Comparison of the prognostic value of inflammation-based scores in early recurrent hepatocellular carcinoma after hepatectomy. Liver Int 40:229–239. https://doi.org/10.1111/liv.14281CrossRefPubMed

Wang MD et al (2020) Early and late recurrence of hepatitis B virus-associated hepatocellular carcinoma. Oncologist 25:e1541–e1551. https://doi.org/10.1634/theoncologist.2019-0944CrossRefPubMedPubMedCentral

Wang WQ et al (2023) Repeat hepatectomy versus microwave ablation for solitary and small (</=3 cm) recurrent hepatocellular carcinoma with early or late recurrence: a propensity score matched study. Eur J Surg Oncol. 49:1001–1008. https://doi.org/10.1016/j.ejso.2022.12.016CrossRefPubMed

Wei T et al (2021) Early versus late recurrence of hepatocellular carcinoma after surgical resection based on post-recurrence survival: an international multi-institutional analysis. J Gastrointest Surg 25:125–133. https://doi.org/10.1007/s11605-020-04553-2CrossRefPubMed

Xia Y et al (2019) Long-term effects of repeat hepatectomy vs percutaneous radiofrequency ablation among patients with recurrent hepatocellular carcinoma: a randomized clinical trial JAMA. Oncol. https://doi.org/10.1001/jamaoncol.2019.4477CrossRef

Xiao H et al (2019) Treatment selection of recurrent hepatocellular carcinoma with microvascular invasion at the initial hepatectomy. Am J Transl Res 11:1864–1875PubMedPubMedCentral

Xing H et al (2019) Repeat hepatectomy for patients with early and late recurrence of hepatocellular carcinoma: a multicenter propensity score matching analysis. Surgery. https://doi.org/10.1016/j.surg.2019.11.005CrossRefPubMedPubMedCentral

Zhang X, Li J, Shen F, Lau WY (2018) Significance of presence of microvascular invasion in specimens obtained after surgical treatment of hepatocellular carcinoma. J Gastroenterol Hepatol 33:347–354. https://doi.org/10.1111/jgh.13843CrossRefPubMed

Titel: Repeat hepatectomy versus percutaneous ablation for recurrent hepatocellular carcinoma: emphasis on the impact of early or late recurrence
verfasst von: Chenwei Wang
Kai Li
Zhenkun Huang
Yichuan Yuan
Wei He
Yun Zheng
Ruhai Zou
Binkui Li
Yunfei Yuan
Jiliang Qiu
Publikationsdatum: 26.08.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Cancer Research and Clinical Oncology / Ausgabe 16/2023
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-023-05286-w

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Repeat hepatectomy versus percutaneous ablation for recurrent hepatocellular carcinoma: emphasis on the impact of early or late recurrence