Risk factors of early recurrence after curative hepatectomy in hepatocellular carcinoma

Hong, Young Mi; Cho, Mong; Yoon, Ki Tae; Chu, Chong Woo; Yang, Kwangho; Park, Yong Mok; Rhu, Je Ho

doi:10.1177/1010428317720863

Cited by 35 publications

(27 citation statements)

References 43 publications

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“…The patients were divided into two categories, each based on the initial AFP level (<100 ng/mL, ≥100 ng/mL) and tumor size (<5 cm, ≥5 cm). The AFP changes (from baseline to preoperative status) were classified into two groups: absent: AFP decreased <50%; present: AFP decreased ≥50% 22 …”

Section: Methodsmentioning

confidence: 99%

Tumor Stiffness Measurements on MR Elastography for Single Nodular Hepatocellular Carcinomas Can Predict Tumor Recurrence After Hepatic Resection

Park

Yoon

Lee

et al. 2020

Magnetic Resonance Imaging

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BackgroundTumor stiffness (TS), measured by magnetic resonance elastography (MRE), could be associated with tumor mechanical properties and tumor grade.PurposeTo determine whether TS obtained using MRE is associated with survival in patients with single nodular hepatocellular carcinoma (HCC) after hepatic resection (HR).Study TypeRetrospective.PopulationIn all, 95 patients with pathologically confirmed HCCs.Field Strength/Sequence1.5T/3D spin‐echo echo‐planar imaging MRE.AssessmentTS values of the whole tumor (TS‐WT) and of a solid portion of the tumor (TS‐SP) after excluding the necrotic area were measured on stiffness maps. Known imaging prognostic factors of HCC were also analyzed. After surgery, pathologic findings were evaluated from resected pathology specimens.Statistical TestsFisher's exact test and the Mann–Whitney U‐test were performed to determine the significance of differences according to the tumor grade. Overall survival (OS) / recurrence‐free survival (RFS) analyses were performed using Kaplan–Meier analyses and Cox multivariable models.ResultsThe average TS‐WT was 2.14 ± 0.74 kPa, and the average TS‐SP was 2.51 ± 1.07 kPa. The cumulative incidence of RFS was 73.1%, 63.1%, and 57.3% at 1, 3, and 5 years, respectively. The TS‐WT, TS‐SP, and tumor size (≥5 cm) were significant prognostic factors for RFS (P < 0.001; P < 0.001; P = 0.017, respectively). The estimated overall 1‐, 3‐, and 5‐year survival rates were 95.7%, 86.9%, and 80.8%, respectively. The alpha‐fetoprotein changes, platelets, tumor size (≥5 cm), and vascular invasion in pathology were significant predictive factors for overall survival (all P < 0.05). Tumor necrosis, TS‐WT, TS‐SP, and vascular invasion in pathology were significantly correlated with poorly differentiated HCC (all P < 0.05).Data ConclusionThe TS‐WT, TW‐SP, and tumor size (≥5 cm) were significant predictive factors of RFS after HR in patients with HCC.Level of EvidenceTechnical Efficacy Stage 5J. MAGN. RESON. IMAGING 2021;53:587–596.

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Section: Methodsmentioning

confidence: 99%

Tumor Stiffness Measurements on MR Elastography for Single Nodular Hepatocellular Carcinomas Can Predict Tumor Recurrence After Hepatic Resection

Park

Yoon

Lee

et al. 2020

Magnetic Resonance Imaging

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“…Increased serum DCP levels have been detected in patients with HCC [60] and they correlate with the degree of HCC malignancy, including the presence of intrahepatic metastases, capsule infiltration, and portal vein invasion [61,62] . Moreover, HCC expressing normal levels of AFP and increased levels of DCP showed a lower grade of differentiation and more frequent MVI [63,64] . For these reasons, DCP has been proposed as a stronger predictor of HCC recurrence after LT than AFP [61,65] .…”

Section: Dcpmentioning

confidence: 99%

Risk factors for hepatocellular carcinoma recurrence after liver transplantation

Toniutto¹,

Fornasiere²,

Fumolo³

et al. 2020

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Liver transplantation (LT) provides an excellent option for the long-term survival of patients with unresectable hepatocellular carcinoma (HCC) based on the Milan criteria. Despite careful selection of patients, HCC may still recur after LT, which represents the most important negative predictor of post-transplant survival. The growing demand for LT in HCC has led to the expansion of patient selection criteria, with a resultant increase in the risk of post-transplant HCC recurrence. Numerous tumor and host factors predict HCC recurrence. The morphological, histological, and serological characteristics of tumors in predicting HCC recurrence have been extensively studied. Furthermore, the type and duration of anticancer response before LT has also been considered a surrogate marker of tumor aggressiveness and is associated with the risk of recurrence. The demographic and clinical characteristics of recipients, as well as the type and duration of exposure to immunosuppressive therapy, represent the main hostrelated risk factors. Many studies have attempted to describe predictive models for the risk of HCC recurrence, considering evaluable parameters both before and after LT. Although many models have been proposed, relatively few have been externally validated on different patient populations. This paper aims to comprehensively summarize the available data on the predictive factors of HCC recurrence after LT, and to examine and discuss those that have been externally validated.

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“…Up-regulation of DCP has been found to correlate with the degree of malignancy of HCC, as DCP-positive tumors are characterized by increased likelihoods of intrahepatic metastasis, capsule infiltration, and portal venous invasion[56,57]. Moreover, the DCP-positive and AFP-negative tumors are more aggressive, for high risk of recurrence after treatment, since they are usually larger tumors with a poor grade of differentiation and vascular invasion[58,59].…”

Section: Serum Biological Markers Related With Tumor Biologymentioning

confidence: 99%

Serum biomarkers and risk of hepatocellular carcinoma recurrence after liver transplantation

Cítores¹,

Lucena²,

Fuente³

et al. 2019

WJH

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Liver transplantation (LT) is the only potentially curative treatment for selected patients with cirrhosis and hepatocellular carcinoma (HCC) who are not candidates for resection. When the Milan criteria are strictly applied, 75% to 85%of 3- to 4-year actuarial survival rates are achieved, but up to 20% of the patients experience HCC recurrence after transplantation. The Milan criteria are based on the preoperative tumor macromorphology, tumor size and number on computed tomography or magnetic resonance imaging that neither correlate well with posttransplant histological study of the liver explant nor accurately predict HCC recurrence after LT, since they do not include objective measures of tumor biology. Preoperative biological markers, including alpha-fetoprotein, des-gamma-carboxiprothrombin or neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio, can predict the risk for HCC recurrence after transplantation. These biomarkers have been proposed as surrogate markers of tumor differentiation and vascular invasion, with varied risk magnitudes depending on the defined cutoffs. Different studies have shown that the combination of one or several biomarkers integrated into prognostic models predict the risk of HCC recurrence after LT more accurately than Milan criteria alone. In this review, we focus on the potential utility of these serum biological markers to improve the performance of Milan criteria to identify patients at high risk of tumoral recurrence after LT.

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Risk factors of early recurrence after curative hepatectomy in hepatocellular carcinoma

Cited by 35 publications

References 43 publications

Tumor Stiffness Measurements on MR Elastography for Single Nodular Hepatocellular Carcinomas Can Predict Tumor Recurrence After Hepatic Resection

Tumor Stiffness Measurements on MR Elastography for Single Nodular Hepatocellular Carcinomas Can Predict Tumor Recurrence After Hepatic Resection

Risk factors for hepatocellular carcinoma recurrence after liver transplantation

Serum biomarkers and risk of hepatocellular carcinoma recurrence after liver transplantation

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