Patterns, Risk Factors, and Outcomes of Recurrence After Hepatectomy for Hepatocellular Carcinoma with and without Microvascular Invasion.

IF 4.2 3区 医学 Q2 ONCOLOGY Journal of Hepatocellular Carcinoma Pub Date : 2024-05-08 eCollection Date: 2024-01-01 DOI:10.2147/JHC.S438850
Yang Yu, Xiao-Hui Wang, Wen-Jie Hu, De-Hua Chen, Zi-Li Hu, Shao-Qiang Li
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Abstract

Purpose: The patterns and risk factors of postsurgical recurrence of patient with hepatocellular carcinoma (HCC) with microvascular invasion (MVI) are not clarified. This study aimed to decipher and compare the postoperative recurrent patterns and the risk factors contributing to recurrence between MVI positive (MVI(+)) and MVI negative (MVI(-)) HCC after hepatectomy.

Patients and methods: Patients with HCC who underwent hepatectomy in three Chinese academic hospitals between January 1, 2009, and December 31, 2018, were enrolled. Recurrent patterns included early (≤2 years) or late (>2 years) recurrence, recurrent sites and number, and risk factors of recurrence were compared between the MVI(+)and MVI(-) groups by propensity score-matching (PSM).

Results: Of 1756 patients included, 581 (33.1%) were MVI(+), and 875 (49.8%) patients developed early recurrence. Compared with the MVI(-) group, the MVI(+) group had a higher 2-year recurrence rate in the PSM cohort (hazard ratio [HR], 1.82; 95% confidence interval [CI], 1.59-2.10; P < 0.001), and more patients with multiple tumor recurrence. Patients with early recurrence in the MVI(+) group had a worse overall survival (OS) than those in the MVI(-) group (HR, 1.24; 95% CI, 1.02-1.50; P = 0.034). Resection margin (RM) ≤1.0 cm is a surgical predictor of early recurrence for the MVI(+) group (HR, 0.68; 95% CI, 0.54-0.87; P = 0.002), but not for the MVI(-) group.

Conclusion: Compared to MVI(-) HCC, MVI(+) HCC tends to be early, multiple recurrence and lung and lymph node metastasis after resection. RM ≤1.0 cm is a surgical risk factor of early recurrence for patient with MVI.

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伴有或不伴有微血管侵犯的肝细胞癌肝脏切除术后复发的模式、风险因素和预后。
目的:微血管侵犯(MVI)肝细胞癌(HCC)患者术后复发的模式和风险因素尚未明确。本研究旨在解读和比较微血管侵犯阳性(MVI(+))和微血管侵犯阴性(MVI(-))肝癌患者肝切除术后的术后复发模式和导致复发的风险因素。患者和方法:纳入2009年1月1日至2018年12月31日期间在中国三家学术医院接受肝切除术的HCC患者。复发模式包括早期(≤2年)或晚期(>2年)复发、复发部位和数量,并通过倾向得分匹配(PSM)比较了MVI(+)组与MVI(-)组之间的复发风险因素:结果:在纳入的1756例患者中,581例(33.1%)为MVI(+),875例(49.8%)为早期复发。与MVI(-)组相比,MVI(+)组在PSM队列中的2年复发率更高(危险比[HR],1.82;95%置信区间[CI],1.59-2.10;P<0.001),且多发肿瘤复发患者更多。MVI(+)组早期复发患者的总生存率(OS)低于MVI(-)组(HR,1.24;95% CI,1.02-1.50;P = 0.034)。切除边缘(RM)≤1.0厘米是MVI(+)组早期复发的手术预测因子(HR,0.68;95% CI,0.54-0.87;P = 0.002),而MVI(-)组则不是:结论:与 MVI(-)HCC 相比,MVI(+)HCC 更倾向于早期、多次复发以及切除后的肺转移和淋巴结转移。RM≤1.0厘米是MVI患者早期复发的手术风险因素。
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来源期刊
CiteScore
0.50
自引率
2.40%
发文量
108
审稿时长
16 weeks
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