Therapeutic efficacy and prognostic indicators in re-resection for recurrent hepatocellular carcinoma: Insights from a retrospective study

IF 1.4 Q3 SURGERY Surgery open science Pub Date : 2025-01-01 DOI:10.1016/j.sopen.2024.12.004
Qi Fan MM , Pengcheng Wei MM , Delin Ma MD , Qian Cheng MD , Jie Gao MD , Jiye Zhu MD , Zhao Li MD
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Abstract

Aims

To evaluate the efficacy of re-resection in recurrent hepatocellular carcinoma (rHCC), identify prognostic factors, and provide clinical guidance.

Methods

A retrospective analysis was conducted on 130 rHCC patients undergoing re-resection and 60 primary HCC patients undergoing initial hepatectomy at Peking University People's Hospital (2014–2022). Disease-free survival (DFS) and overall survival (OS) were compared. Prognostic factors were identified using univariate and multivariate COX regression analyses.

Results

Baseline characteristics were comparable between groups (P > 0.05). DFS was similar between groups (30.8 vs. 32.2 months, P = 0.612). The 1-year, 2-year, and 3-year DFS rates for the re-resection group were 88.5 %, 64.9 %, and 56.7 %, respectively, versus 88.3 %, 65.0 %, and 53.3 % for the primary resection group. OS was lower in the re-resection group (36.1 vs. 47.2 months, P = 0.041) with 1-year, 2-year, and 3-year OS rates of 90.8 %, 73.1 %, and 60.0 %, compared to 95.0 %, 80.0 %, and 68.3 % for the primary resection group. Significant factors affecting DFS were Child-Pugh classification (P = 0.044), time to recurrence (P = 0.002), tumor differentiation (P = 0.044), and satellite nodules (P = 0.019). Factors influencing OS included Child-Pugh classification (P = 0.040), time to recurrence (P = 0.002), and tumor differentiation (P = 0.032).

Conclusions

Re-resection is an effective treatment option for rHCC, with favorable outcomes as measured by DFS and OS, though OS is lower compared to initial hepatectomy. Key prognostic factors include Child-Pugh classification, time to recurrence, tumor differentiation, and satellite nodules.
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复发性肝细胞癌再切除术的疗效和预后指标:来自回顾性研究的见解。
目的:评价再切除治疗复发性肝细胞癌(rHCC)的疗效,探讨影响预后的因素,为临床提供指导。方法:回顾性分析2014-2022年北京大学人民医院再次行肝癌切除术的130例rHCC患者和首次行肝切除术的60例原发性HCC患者。比较无病生存期(DFS)和总生存期(OS)。采用单因素和多因素COX回归分析确定预后因素。结果:两组间基线特征具有可比性(P < 0.05)。两组间DFS相似(30.8个月vs. 32.2个月,P = 0.612)。再切除组的1年、2年和3年DFS分别为88.5%、64.9%和56.7%,而首次切除组的DFS分别为88.3%、65.0%和53.3%。再切除组的OS较低(36.1个月vs. 47.2个月,P = 0.041), 1年、2年和3年的OS率分别为90.8%、73.1%和60.0%,而首次切除组的OS率分别为95.0%、80.0%和68.3%。影响DFS的显著因素为Child-Pugh分型(P = 0.044)、复发时间(P = 0.002)、肿瘤分化(P = 0.044)、卫星结节(P = 0.019)。影响OS的因素包括Child-Pugh分型(P = 0.040)、复发时间(P = 0.002)和肿瘤分化(P = 0.032)。结论:再切除是rHCC的有效治疗选择,通过DFS和OS来衡量具有良好的结果,尽管OS比初始肝切除术低。关键预后因素包括Child-Pugh分类、复发时间、肿瘤分化和伴发结节。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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