Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2015 Jan 28;21(4):1207-15.
doi: 10.3748/wjg.v21.i4.1207.

Optimal duration of the early and late recurrence of hepatocellular carcinoma after hepatectomy

Yusuke Yamamoto  1 , Hisashi Ikoma  1 , Ryo Morimura  1 , Hirotaka Konishi  1 , Yasutoshi Murayama  1 , Shuhei Komatsu  1 , Atsushi Shiozaki  1 , Yoshiaki Kuriu  1 , Takeshi Kubota  1 , Masayoshi Nakanishi  1 , Daisuke Ichikawa  1 , Hitoshi Fujiwara  1 , Kazuma Okamoto  1 , Chouhei Sakakura  1 , Toshiya Ochiai  1 , Eigo Otsuji  1
Affiliations
Comparative Study

Optimal duration of the early and late recurrence of hepatocellular carcinoma after hepatectomy

Yusuke Yamamoto et al. World J Gastroenterol. .

Abstract

Aim: To determine the best cut-off value between the early and late recurrence periods after the initial recurrence of hepatocellular carcinoma (HCC).

Methods: The clinical records of 404 patients who underwent macroscopic curative hepatectomy for HCC between 1980 and 2010 were retrospectively examined. We divided the 252 patients experienced a recurrence of HCC into two groups, the early and late recurrence groups using the "minimum P-value" approach. Factors for early recurrence were investigated using all 404 patients, and factors related to late recurrence were investigated in the patients who were confirmed to be recurrence free at the end of the early recurrence period.

Results: For the 252 patients who experienced a recurrence, the optimal cut-off value for differentiating early and late recurrence based on the overall survival after initial recurrence was 17 mo (5-year overall survival after initial recurrence: 15.4% vs 36.3%, P=0.000018). Cox proportional hazard analysis identified early recurrence (P=0.003) as one of the independent prognostic factors associated with overall survival after initial recurrence. A logistic regression model showed that an alpha-fetoprotein level>100 ng/mL (P<0.001), multiple HCC (P<0.001), serosal invasion (P=0.031), and microvascular invasion (P=0.012) were independent factors associated with early recurrence, whereas the only independent factor related to late recurrence was liver cirrhosis (P=0.002).

Conclusion: Seventeen months after hepatectomy is a useful cut-off value between early and late recurrence of HCC based on the prognosis and different etiologies.

Keywords: Early recurrence; Hepatectomy; Hepatocellular carcinoma; Late recurrence; Minimum P-value approach.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Kaplan-Meier analysis of the interval between the initial hepatectomy and recurrence. The minimum P value approach indicated that the most significant cut-off value for the interval prior to recurrence time was 17 mo. OS: Overall survival.
Figure 2
Figure 2
Comparison of the overall survival curves after initial hepatic recurrence for the early and late recurrence groups. The overall survival (OS) after initial recurrence in the late recurrence group was significantly better than that of the early recurrence group (5-year OS after initial recurrence: 36.3% vs 15.4%, P = 0.000018).
See this image and copyright information in PMC

References

    1. Bosch FX, Ribes J, Díaz M, Cléries R. Primary liver cancer: worldwide incidence and trends. Gastroenterology. 2004;127:S5–S16. - PubMed
    1. Wu CC, Cheng SB, Ho WM, Chen JT, Liu TJ, P’eng FK. Liver resection for hepatocellular carcinoma in patients with cirrhosis. Br J Surg. 2005;92:348–355. - PubMed
    1. Yamamoto Y, Ikoma H, Morimura R, Konishi H, Murayama Y, Komatsu S, Shiozaki A, Kuriu Y, Kubota T, Nakanishi M, et al. Changing trends in long-term outcomes after hepatic resection for hepatocellular carcinoma: A 30-year, single-center experience. Anticancer Res. 2013;33:5097–5105. - PubMed
    1. Shimada M, Takenaka K, Gion T, Fujiwara Y, Kajiyama K, Maeda T, Shirabe K, Nishizaki T, Yanaga K, Sugimachi K. Prognosis of recurrent hepatocellular carcinoma: a 10-year surgical experience in Japan. Gastroenterology. 1996;111:720–726. - PubMed
    1. Hayashi M, Shimizu T, Hirokawa F, Inoue Y, Komeda K, Asakuma M, Miyamoto Y, Takeshita A, Shibayama Y, Tanigawa N. Clinicopathological risk factors for recurrence within one year after initial hepatectomy for hepatocellular carcinoma. Am Surg. 2011;77:572–578. - PubMed

Publication types

MeSH terms

LinkOut - more resources