Patterns, treatments, and prognosis of tumor recurrence after resection for hepatocellular carcinoma with microvascular invasion: a multicenter study from China

Chen, Zhenhua; Zhang, Xiuping; Feng, Jin-Kai; Li, Le‐Qun; Zhang, Fan; Hu, Yiren; Zhong, Chengzong; Wang, Kang; Chai, Zong‐Tao; Wei, Xiao‐Hong; Shi, Jie; Guo, Wei-Xing; Wu, Mengchao; Lau, Wan Yee; Cheng, Shuqun

doi:10.1016/j.hpb.2021.11.016

Cited by 14 publications

(10 citation statements)

References 37 publications

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“…In addition to CTCs, the presence of MVI and satellite nodules was also taken as risk factors for EPR. Both the MVI and satellite nodules are evidence of HCC invasion and metastasis [6, 44,45]. Numerous previous studies as well as the current study showed that the MVI and satellite nodules play an important role in HCC recurrence [44][45][46][47].…”

Section: Discussionmentioning

confidence: 75%

Prognostic potential of preoperative circulating tumor cells to predict the early progression recurrence in hepatocellular carcinoma patients after hepatectomy

Zhan

Yang

et al. 2023

Preprint

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Background The role of circulating tumor cells (CTCs) in prognosis prediction has been actively studied in hepatocellular carcinoma (HCC) patients. However, their efficiency in accurately predicting early progression recurrence (EPR) is unclear. This study aimed to investigate the clinical potential of preoperative CTCs to predict EPR in HCC patients after hepatectomy. Methods 145 HCC patients, whose preoperative CTCs were detected, were enrolled. Based on the recurrence times and types, the patients were divided into four groups, including early oligo-recurrence (EOR), EPR, late oligo-recurrence (LOR), and late progression recurrence (LPR). Results Among the 145 patients, 133 (91.7%) patients had a postoperative recurrence, including 51 EOR, 42 EPR, 39 LOR, and 1 LPR patient. Kaplan–Meier survival curve analysis indicated that the HCC patients with EPR had the worst OS. There were significant differences in the total-CTCs (T-CTCs) and CTCs subtypes count between the EPR group with EOR and LOR groups. Cox regression analysis indicated that the T-CTC count of >5/5 mL,the presence of microvascular invasion (MVI)and satellite nodules were the independent risk factors for EPR. The efficiency of T-CTCs was superior as compared to those of the other indicators in predicting EPR. Moreover, the combined model demonstrated a markedly superior area under the curve (AUC). Conclusions the HCC patients with EPR had the worst OS. The preoperative CTCs might serve as a prognostic indicator of EPR for HCC patients. The combined models, including T-CTCs, MVI, and satellite nodules, had the best performance to predict EPR after hepatectomy.

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Section: Discussionmentioning

confidence: 75%

Prognostic potential of preoperative circulating tumor cells to predict the early progression recurrence in hepatocellular carcinoma patients after hepatectomy

Zhan

Yang

et al. 2023

Preprint

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“…Currently, surgical resection and radiofrequency ablation (RFA) are viewed as radical treatments for early-stage HCC patients [3][4][5]. Nevertheless, the outcome of HCC patients is still unfavorable, with a 5-year recurrence rate ranging from 60 to 70% [6][7][8]. Considering that HCC is a major public health concern, prognosis prediction is crucial to promote the management of HCC patients.…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging-based rim enhancement could effectually predict poor prognosis in hepatocellular carcinoma: a meta-analysis

Lu,

Cen,

et al. 2024

European Journal of Gastroenterology &Amp; Hepatology

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Recent studies have initially shown that MRI-based rim enhancement associates with poor prognosis in hepatocellular carcinoma (HCC) patients, but their sample sizes are small, leading to a necessary of comprehensive analyses to make a relatively solid statement. Thus, this meta-analysis aimed to summarize the correlation between MRI-based rim enhancement and prognosis in HCC patients. Until March 2023, a literature search was conducted on Web of Science, PubMed, EMBASE, Cochrane, CNKI, Wangfang, and CQVIP databases in order to identify studies that report the correlation between MRI-based rim enhancement and the prognosis of HCC patients. MRI-based rim enhancement and prognostic data were extracted and analyzed. In our study, eight studies containing 1816 HCC patients were analyzed. Generally, the presence of MRI-based rim enhancement was related to shortened disease-free survival (DFS) [hazard ratio (HR): 2.77, 95% confidence interval (CI): 2.11–3.62, P < 0.001], and worse overall survival (OS) (HR: 5.43, 95% CI: 2.14–13.79, P < 0.001). While no other prognostic data could be retrieved. Funnel plots, Begg’s test, and Egger’s test all indicated that no publication bias existed; and the risk score by Newcastle-Ottawa Scale criteria ranged from 7–9 points, suggesting a generally low risk of bias. Meanwhile, the sensitivity analysis showed that the significant findings did not change by omitting each study. Then, subgroup analyses revealed that no matter stratified by tumor size, treatment option, or sample size, rim enhancement was linked with unsatisfied DFS (all P < 0.05). Conclusively, MRI-based rim enhancement could effectually estimate poor survival in HCC patients, indicating its good prognostic value.

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“…There are two types of postoperative recurrence, one is early recurrence which is thought to be associated with intrahepatic metastasis from the initial tumor within 2 years after the surgery; the other is late recurrence, which usually occurs after two years due to underlying liver disease like cirrhosis or active hepatitis. Previous studies have shown that portal vein tumor thrombosis(PVTT), microvascular invasion (MVI), and multiple tumors et al are high-risk factors for early recurrence (10-13), while PVTT and MVI are also high-risk factors for late recurrence (14,15). Patients with high risk factors are more likely to experience early recurrence, which severely affects the overall outcome of surgical treatment and compromises the patient's quality of life.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have shown that portal vein tumor thrombosis(PVTT), microvascular invasion (MVI), and multiple tumors et al. are high-risk factors for early recurrence ( 10 – 13 ), while PVTT and MVI are also high-risk factors for late recurrence ( 14 , 15 ). Patients with high risk factors are more likely to experience early recurrence, which severely affects the overall outcome of surgical treatment and compromises the patient’s quality of life.…”

Section: Introductionmentioning

confidence: 99%

Adjuvant therapy following curative treatments for hepatocellular carcinoma: current dilemmas and prospects

et al. 2023

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Curative surgical treatments, mainly liver resection, are still one of the optimal options for patients with early-, mid-, and even progression-stage hepatocellular carcinoma (HCC). However, the recurrence rate within 5 years after surgery is as high as 70%, especially in patients with high risk factors for recurrence, most of whom experience early recurrence within 2 years. Effective adjuvant therapy may improve prognosis, previous studies found that adjuvant transarterial chemoembolization, antiviral, and traditional Chinese medicine et al. were helpful in preventing HCC recurrence. Nevertheless, due to controversial results or lack of high-level evidence, there is no standardized postoperative management protocol worldwide at present. Continued exploration of effective postoperative adjuvant treatments to improve surgical prognosis is necessary.

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Patterns, treatments, and prognosis of tumor recurrence after resection for hepatocellular carcinoma with microvascular invasion: a multicenter study from China

Cited by 14 publications

References 37 publications

Prognostic potential of preoperative circulating tumor cells to predict the early progression recurrence in hepatocellular carcinoma patients after hepatectomy

Prognostic potential of preoperative circulating tumor cells to predict the early progression recurrence in hepatocellular carcinoma patients after hepatectomy

Magnetic resonance imaging-based rim enhancement could effectually predict poor prognosis in hepatocellular carcinoma: a meta-analysis

Adjuvant therapy following curative treatments for hepatocellular carcinoma: current dilemmas and prospects

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