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Substantial risk of recurrence even after 5 recurrence-free years in early-stage hepatocellular carcinoma patients

Clinical and Molecular Hepatology 2020년 26권 4호 p.516 ~ 528
김지혜, 강원석, 신동현, 곽금연, 백용한, 최문석, 이준혁, 고광철, 백승운,
소속 상세정보
김지혜 ( Kim Ji-Hye ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
강원석 ( Kang Won-Seok ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
신동현 ( Sinn Dong-Hyun ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
곽금연 ( Gwak Geum-Youn ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
백용한 ( Paik Yong-Han ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
최문석 ( Choi Moon-Seok ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
이준혁 ( Lee Joon-Hyeok ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
고광철 ( Koh Kwang-Cheol ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
백승운 ( Paik Seung-Woon ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine

Abstract


Background/Aims: Although hepatocellular carcinoma (HCC) is notorious for its high recurrence rate, some patients do not experience recurrence for more than 5 years after resection or radiofrequency ablation for early-stage HCC. For those with five recurrence-free period, the risk of HCC recurrence within the next 5 years remains unknown.

Methods: A total of 1,451 consecutive patients (median, 55 years old; males, 79.0%; hepatitis B virus-related, 79.3%) with good liver function (Child-Pugh class A) diagnosed with early-stage HCC by Barcelona Clinic Liver Cancer Staging and received radiofrequency ablation or resection as an initial treatment between 2005 and 2010 were analyzed.

Results: During a median follow-up period of 8.1 years, 961 patients (66.2%) experienced HCC recurrence. The cumulative recurrence rates increased to 39.7%, 60.3%, and 71.0% at 2, 5, and 10 years, respectively, and did not reach a plateau. Five years after HCC diagnosis, 487 patients were alive without experiencing a recurrence. Among them, during a median of 3.9 additional years of follow-up (range, 0.1?9.0 years), 127 patients (26.1%) experienced recurrence. The next 5-year cumulative recurrence rate (5?10 years from initial diagnosis) was 27.0%. Male sex, higher fibrosis-4 scores, and alpha-fetoprotein levels at 5 years were associated with later HCC recurrence among patients who did not experience recurrence for more than 5 years.

Conclusions: The HCC recurrence rate following 5 recurrence-free years after HCC treatment was high, indicating that HCC patients warrant continued HCC surveillance, even after 5 recurrence-free years.

키워드

Carcinoma, Hepatocellular; Treatment; Long-term; Recurrence

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