Risk factors contributing to early and late phase intrahepatic recurrence of hepatocellular carcinoma after hepatectomy

TLDR

The study retrospectively examined factors associated with early and late intrahepatic recurrence of hepatocellular carcinoma after hepatectomy. A Cox regression analysis of 249 HCC patients who underwent hepatectomy was performed, censoring recurrence‑free patients at 2 years to identify predictors of early and late recurrence. Early recurrence was linked to non‑anatomical resection, microscopic vascular invasion, and AFP ≥ 32 ng/mL, whereas late recurrence correlated with higher hepatitis activity grade, multiple tumors, and gross tumor classification, indicating distinct metastatic and de‑novo mechanisms.

Abstract

We conducted a retrospective cohort study to investigate factors to early and late phase recurrence of hepatocellular carcinoma (HCC).The study population consisted of 249 patients including 157 with cirrhosis who underwent hepatectomy for HCC. The endpoint was time-to-recurrence. Using a Cox regression model, factors to early and late phase recurrences were investigated censoring recurrence-free patients at the 2-year time point and in patients without recurrence at 2 years.Actuarial probability of overall recurrence at 1, 3, and 5 years were 0.301, 0.623, and 0.790, respectively, with a median follow-up of 624 days. Early recurrence was observed in 123 out of 249 patients; while late recurrence was found in 61 out of 113 patients. Factors to early recurrence were as follows: non-anatomical resection, presence of microscopic vascular invasion, and serum alpha-fetoprotein level >or=32 ng/ml. Those contributing to late phase recurrence were higher grade of hepatitis activity, multiple tumors, and gross tumor classification.Variables associated with metastatic recurrence were factors to early phase recurrence; whereas those related with elevated carcinogenesis contributed to late phase recurrence, thus providing an epidemiological evidence that different mechanisms, i.e. metastasis and de novo, are involved in intrahepatic recurrence after hepatectomy for HCC.