A reasonable identification of the early recurrence time based on microvascular invasion for hepatocellular carcinoma after R0 resection: A multicenter retrospective study

• Published in: Cancer medicine (Malden, MA) Vol. 12; no. 9; pp. 10294 - 10302
• Main Authors: Liu, Zong‐Han, Chai, Zong‐Tao, Feng, Jin‐Kai, Hou, Yu‐Chao, Zhang, Xiu‐Ping, Chen, Zhen‐Hua, Xiang, Yan‐Jun, Guo, Wei‐Xing, Shi, Jie, Cheng, Shu‐Qun
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.05.2023; John Wiley and Sons Inc; Wiley
• Subjects: Adjuvants, Immunologic; Carcinoma, Hepatocellular - pathology; Catheters; Chemoembolization, Therapeutic - methods; early recurrence; Hepatectomy; Hepatocellular carcinoma; hepatocellular carcinoma (HCC); Humans; Liver cancer; Liver Neoplasms - pathology; Magnetic resonance imaging; Medical imaging; Medical prognosis; Metastasis; microvascular invasion (MVI); Microvasculature; Multivariate analysis; Neoplasm Invasiveness; Neoplasm Recurrence, Local - pathology; Patients; Retrospective Studies; Risk factors; Surgery; Survival; Tomography; transcatheter arterial chemoembolization (TACE); Tumors; Ultrasonic imaging; transcatheter arterial chemoembolization (TACE); hepatocellular carcinoma (HCC); early recurrence; microvascular invasion (MVI)
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.5758

Background Early and late recurrence of hepatocellular carcinoma (HCC) have different clinical outcomes, especially for those accompanied by microvascular invasion (MVI), but the definition of early recurrence remains controversial. Therefore, a reasonable identification of the early recurrence time for HCC is urgently needed. Methods Resected recurrence patients were enrolled and divided into two cohorts, one for identification of the early recurrence time and another for verification of the accuracy of the point. Univariable and multivariable Cox regression analyses were adopted to identify the prognostic factors of recurrence HCC (rHCC) and Kaplan–Meier method was applied to analyze the overall survival (OS). The appropriate cutoff value was determined by the exhaustive method using different recurrence intervals from 1 to 24 months in turn. Results In total, 292 resected rHCC patients were analyzed to calculate the early recurrence interval, and another 421 resected rHCC patients with MVI were enrolled to verify the efficacy of adjuvant transarterial chemoembolization (TACE) in this recurrence interval. MVI was identified as an independent risk factor by multivariable analysis. The OS of rHCC patients without MVI is better than that of patients with MVI when the recurrence time was within 13 months, while not beyond 13 months. The verification cohort demonstrated that adjuvant TACE provided longer survival for rHCC with MVI when the recurrence time was within 13 months, while not beyond 13 months. Conclusion For HCC patients with MVI who underwent R0 resection, 13 months may be a reasonable early recurrence time point, and within this interval, postoperative adjuvant TACE may result in longer survival compared with surgery alone. For hepatocellular carcinoma (HCC) patients who suffered recurrence, 13 months may be the appropriate identification for early recurrent HCC with MVI, and adjuvant TACE (transcatheter arterial chemoembolization) may give longer survival within this period.