Predictors of non-transplantable recurrence in hepatocellular carcinoma patients treated with frontline liver resection
© 2023 The Authors. Liver International published by John Wiley & Sons Ltd..
BACKGROUND AND AIMS: Hepatocellular carcinoma (HCC) recurrence is common in patients treated with liver resection (LR). In this study, we aimed to evaluate the incidence and preoperative predictors of non-transplantable recurrence in patients with single HCC ≤5 cm treated with frontline LR.
METHODS: From the Italian Liver Cancer (ITA.LI.CA) database, 512 patients receiving frontline LR for single HCC ≤5 cm were retrieved. Incidence and predictors of recurrence beyond Milan criteria (MC) and up-to-seven criteria were compared between patients with HCC <4 and ≥4 cm.
RESULTS: During a median follow-up of 4.2 years, the overall recurrence rate was 55.9%. In the ≥4 cm group, a significantly higher proportion of patients recurred beyond MC at first recurrence (28.9% vs. 14.1%; p < 0.001) and overall (44.4% vs. 25.2%; p < 0.001). Similar results were found considering recurrence beyond up-to-seven criteria. Compared to those with larger tumours, patients with HCC <4 cm had a longer recurrence-free survival and overall survival. HCC size ≥4 cm and high alpha-fetoprotein (AFP) level at the time of LR were independent predictors of recurrence beyond MC (and up-to-seven criteria). In the subgroup of patients with available histologic information (n = 354), microvascular invasion and microsatellite lesions were identified as additional independent risk factors for non-transplantable recurrence.
CONCLUSIONS: Despite the high recurrence rate, LR for single HCC ≤5 cm offers excellent long-term survival. Non-transplantable recurrence is predicted by HCC size and AFP levels, among pre-operatively available variables. High-risk patients could be considered for frontline LT or listed for transplantation even before recurrence.
| Errataetall: |
CommentIn: Liver Int. 2023 Dec;43(12):2589-2591. - PMID 38011642 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:43 |
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| Enthalten in: |
Liver international : official journal of the International Association for the Study of the Liver - 43(2023), 12 vom: 01. Dez., Seite 2762-2775 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Pelizzaro, Filippo [VerfasserIn] |
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| Links: |
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| Themen: |
Alpha-Fetoproteins |
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| Anmerkungen: |
Date Completed 29.11.2023 Date Revised 26.01.2024 published: Print-Electronic CommentIn: Liver Int. 2023 Dec;43(12):2589-2591. - PMID 38011642 Citation Status MEDLINE |
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| doi: |
10.1111/liv.15719 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM362498652 |
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| 245 | 1 | 0 | |a Predictors of non-transplantable recurrence in hepatocellular carcinoma patients treated with frontline liver resection |
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| 500 | |a Date Completed 29.11.2023 | ||
| 500 | |a Date Revised 26.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Liver Int. 2023 Dec;43(12):2589-2591. - PMID 38011642 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 The Authors. Liver International published by John Wiley & Sons Ltd. | ||
| 520 | |a BACKGROUND AND AIMS: Hepatocellular carcinoma (HCC) recurrence is common in patients treated with liver resection (LR). In this study, we aimed to evaluate the incidence and preoperative predictors of non-transplantable recurrence in patients with single HCC ≤5 cm treated with frontline LR | ||
| 520 | |a METHODS: From the Italian Liver Cancer (ITA.LI.CA) database, 512 patients receiving frontline LR for single HCC ≤5 cm were retrieved. Incidence and predictors of recurrence beyond Milan criteria (MC) and up-to-seven criteria were compared between patients with HCC <4 and ≥4 cm | ||
| 520 | |a RESULTS: During a median follow-up of 4.2 years, the overall recurrence rate was 55.9%. In the ≥4 cm group, a significantly higher proportion of patients recurred beyond MC at first recurrence (28.9% vs. 14.1%; p < 0.001) and overall (44.4% vs. 25.2%; p < 0.001). Similar results were found considering recurrence beyond up-to-seven criteria. Compared to those with larger tumours, patients with HCC <4 cm had a longer recurrence-free survival and overall survival. HCC size ≥4 cm and high alpha-fetoprotein (AFP) level at the time of LR were independent predictors of recurrence beyond MC (and up-to-seven criteria). In the subgroup of patients with available histologic information (n = 354), microvascular invasion and microsatellite lesions were identified as additional independent risk factors for non-transplantable recurrence | ||
| 520 | |a CONCLUSIONS: Despite the high recurrence rate, LR for single HCC ≤5 cm offers excellent long-term survival. Non-transplantable recurrence is predicted by HCC size and AFP levels, among pre-operatively available variables. High-risk patients could be considered for frontline LT or listed for transplantation even before recurrence | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a hepatectomy | |
| 650 | 4 | |a liver cancer | |
| 650 | 4 | |a liver transplantation | |
| 650 | 4 | |a recurrence | |
| 650 | 4 | |a tumour size | |
| 650 | 7 | |a alpha-Fetoproteins |2 NLM | |
| 700 | 1 | |a Trevisani, Franco |e verfasserin |4 aut | |
| 700 | 1 | |a Simeon, Vittorio |e verfasserin |4 aut | |
| 700 | 1 | |a Vitale, Alessandro |e verfasserin |4 aut | |
| 700 | 1 | |a Cillo, Umberto |e verfasserin |4 aut | |
| 700 | 1 | |a Piscaglia, Fabio |e verfasserin |4 aut | |
| 700 | 1 | |a Missale, Gabriele |e verfasserin |4 aut | |
| 700 | 1 | |a Sangiovanni, Angelo |e verfasserin |4 aut | |
| 700 | 1 | |a Foschi, Francesco G |e verfasserin |4 aut | |
| 700 | 1 | |a Cabibbo, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Caturelli, Eugenio |e verfasserin |4 aut | |
| 700 | 1 | |a Di Marco, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Azzaroli, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Brunetto, Maurizia R |e verfasserin |4 aut | |
| 700 | 1 | |a Raimondo, Giovanni |e verfasserin |4 aut | |
| 700 | 1 | |a Vidili, Gianpaolo |e verfasserin |4 aut | |
| 700 | 1 | |a Guarino, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Gasbarrini, Antonio |e verfasserin |4 aut | |
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| 700 | 1 | |a Svegliati-Baroni, Gianluca |e verfasserin |4 aut | |
| 700 | 1 | |a Giannini, Edoardo G |e verfasserin |4 aut | |
| 700 | 1 | |a Mega, Andrea |e verfasserin |4 aut | |
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| 700 | 1 | |a Rapaccini, Gian Ludovico |e verfasserin |4 aut | |
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| 700 | 1 | |a Nardone, Gerardo |e verfasserin |4 aut | |
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| 700 | 0 | |a Italian Liver Cancer (ITA.LI.CA) group |e verfasserin |4 aut | |
| 700 | 1 | |a Biselli, Maurizio |e investigator |4 oth | |
| 700 | 1 | |a Caraceni, Paolo |e investigator |4 oth | |
| 700 | 1 | |a Lani, Lorenzo |e investigator |4 oth | |
| 700 | 1 | |a Rampoldi, Davide |e investigator |4 oth | |
| 700 | 1 | |a Reggidori, Nicola |e investigator |4 oth | |
| 700 | 1 | |a Santi, Valentina |e investigator |4 oth | |
| 700 | 1 | |a Stefanini, Benedetta |e investigator |4 oth | |
| 700 | 1 | |a Granito, Alessandro |e investigator |4 oth | |
| 700 | 1 | |a Muratori, Luca |e investigator |4 oth | |
| 700 | 1 | |a Sansone, Vito |e investigator |4 oth | |
| 700 | 1 | |a Tovoli, Francesco |e investigator |4 oth | |
| 700 | 1 | |a Dajti, Elton |e investigator |4 oth | |
| 700 | 1 | |a Marasco, Giovanni |e investigator |4 oth | |
| 700 | 1 | |a Ravaioli, Federico |e investigator |4 oth | |
| 700 | 1 | |a Cappelli, Alberta |e investigator |4 oth | |
| 700 | 1 | |a Golfieri, Rita |e investigator |4 oth | |
| 700 | 1 | |a Mosconi, Cristina |e investigator |4 oth | |
| 700 | 1 | |a Renzulli, Matteo |e investigator |4 oth | |
| 700 | 1 | |a Pinto, Elisa |e investigator |4 oth | |
| 700 | 1 | |a Palano, Giorgio |e investigator |4 oth | |
| 700 | 1 | |a Kitenge, Maria Piera |e investigator |4 oth | |
| 700 | 1 | |a Bertellini, Federica |e investigator |4 oth | |
| 700 | 1 | |a Cela, Ester Marina |e investigator |4 oth | |
| 700 | 1 | |a Facciorusso, Antonio |e investigator |4 oth | |
| 700 | 1 | |a Pieri, Giulia |e investigator |4 oth | |
| 700 | 1 | |a Torres, Maria Corina Plaz |e investigator |4 oth | |
| 700 | 1 | |a Pasta, Andrea |e investigator |4 oth | |
| 700 | 1 | |a de Matthaeis, Nicoletta |e investigator |4 oth | |
| 700 | 1 | |a Ponziani, Francesca Romana |e investigator |4 oth | |
| 700 | 1 | |a Ghittoni, Giorgia |e investigator |4 oth | |
| 700 | 1 | |a Lauria, Valentina |e investigator |4 oth | |
| 700 | 1 | |a Pelecca, Giorgio |e investigator |4 oth | |
| 700 | 1 | |a Chegai, Fabrizio |e investigator |4 oth | |
| 700 | 1 | |a Raso, Armando |e investigator |4 oth | |
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| 700 | 1 | |a Dall'Aglio, Anna Chiara |e investigator |4 oth | |
| 700 | 1 | |a Ercolani, Giorgio |e investigator |4 oth | |
| 700 | 1 | |a Mirici, Federica |e investigator |4 oth | |
| 700 | 1 | |a Marra, Fabio |e investigator |4 oth | |
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| 700 | 1 | |a Rosi, Martina |e investigator |4 oth | |
| 700 | 1 | |a Coccoli, Pietro |e investigator |4 oth | |
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| 700 | 1 | |a Capasso, Mario |e investigator |4 oth | |
| 700 | 1 | |a Romagnoli, Veronica |e investigator |4 oth | |
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