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. 2024 Mar 5:18:11795549241228232.
doi: 10.1177/11795549241228232. eCollection 2024.

Smoking as a Risk Factor for Very Late Recurrence in Surgically Resected Early-Stage Primary Hepatocellular Carcinoma

Wei-Ru Cho  1 , Chih-Chi Wang  2 , Mu-Jung Tsai  3 , Chih-Che Lin  2 , Yi-Hao Yen  4 , Chien Hung Chen  4 , Yuan-Hung Kuo  4 , Chih-Chien Yao  4 , Chao-Hung Hung  4 , Pao-Yuan Huang  4 , An-Che Liu  4 , Ming-Chao Tsai  4   5
Affiliations

Smoking as a Risk Factor for Very Late Recurrence in Surgically Resected Early-Stage Primary Hepatocellular Carcinoma

Wei-Ru Cho et al. Clin Med Insights Oncol. .

Abstract

Background: The risk of first recurrence of hepatocellular carcinoma (HCC) within years 5 to 10 after curative hepatectomy remains unknown. We aimed to assess the incidence and prognostic factors for very late recurrence among patients who achieved 5 years' recurrence-free survival (RFS) after primary resection.

Methods: We retrospectively analyzed 337 patients with early-stage HCC underwent primary tumor resection and achieved more than 5 years' RFS.

Results: A total of 77 patients (22.8%) developed very late recurrence. The cumulative very late recurrence rate increased from 6.9% and 11.7% to 16.6% at 6, 7, and 8 years, respectively. Patients stopped smoking had a higher rate of very late RFS.

Conclusions: The high rates of very late recurrence in HCC indicate that patients warrant continued surveillance, even after 5 recurrence-free years. Moreover, smoking is a risk factor for very late HCC recurrence, and quitting smoking may reduce the risk of very late recurrence.

Keywords: Hepatocellular carcinoma; long-term; recurrence; smoking.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Patient selection flow diagram. BCLC indicates Barcelona Clinic Liver Cancer; HCC, hepatocellular carcinoma; RFS, recurrence-free survival; KCGMH, Kaohsiung Chang Gung Memorial Hospital; RFA, radiofrequency ablation; TACE, Transcatheter Arterial Chemoembolization.
Figure 2.
Figure 2.
Kaplan-Meier analysis of very late recurrence (A) and overall survival (B) for patients with early-stage HCC who were alive without recurrence at 5 years after primary resection.
Figure 3.
Figure 3.
Kaplan-Meier analysis of very late recurrence-free survival (A) and overall survival (B) for patients who were alive without recurrence at 5 years after primary resection stratified by smoking status.
Figure 4.
Figure 4.
Kaplan-Meier analysis of cumulative very late recurrence-free survival based on smoking status for the subgroups of patients stratified by (A) hepatitis, (B) liver cirrhosis, (C) age, (D) sex, and (E) serum AFP. AFP indicates alpha-fetoprotein, CHB indicates chronic hepatitis B, CHC indicates chronic hepatitis C and LC indicates liver cirrhosis.
See this image and copyright information in PMC

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