TY - JOUR
T1 - Repeat hepatectomy for patients with early and late recurrence of hepatocellular carcinoma
T2 - A multicenter propensity score matching analysis
AU - Xing, Hao
AU - Sun, Li Yang
AU - Yan, Wen Tao
AU - Quan, Bing
AU - Liang, Lei
AU - Li, Chao
AU - Zhou, Ya Hao
AU - Wang, Hong
AU - Zhong, Jian Hong
AU - Gu, Wei Min
AU - Chen, Ting Hao
AU - Wang, Ming Da
AU - Wu, Han
AU - Pawlik, Timothy M.
AU - Lau, Wan Yee
AU - Wu, Meng Chao
AU - Shen, Feng
AU - Yang, Tian
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2021/4
Y1 - 2021/4
N2 - Background: Repeat hepatectomy is a feasible treatment modality for intrahepatic recurrence after hepatectomy of hepatocellular carcinoma, yet the survival benefit remains ill-defined. The objective of the current study was to define long-term, oncologic outcomes after repeat hepatectomy among patients with early and late recurrence. Methods: Patients undergoing curative-intent repeat hepatectomy for recurrent hepatocellular carcinoma were identified using a multi-intuitional database. Early and late recurrence was defined by setting 1 year after initial hepatectomy as the cutoff value. Patient clinical characteristics, overall survival, and disease-free survival were compared among patients with early and late recurrence before and after propensity score matching. Results: Among all the patients, 81 had early recurrence and 129 had late recurrence from which 74 matched pairs were included in the propensity score matching analytic cohort. Before propensity score matching, 5-year overall survival and disease-free survival after resection of an early recurrence were 41.7% and 17.9%, respectively, which were worse compared with patients who had resection of a late recurrence (57.0% and 39.4%, both P <.01). After propensity score matching, 5-year overall survival and disease-free survival among patients with early recurrence were worse compared with patients with late recurrence (41.0% and 19.2% vs 64.3% and 43.2%, both P <.01). After adjustment for other confounding factors on multivariable Cox-regression analysis, early recurrence remained independently associated with decreased overall survival and disease-free survival (hazard ratio 2.22, 95% confidence interval 1.35–3.34, P =.001; hazard ratio 1.86, 95% confidence 1.26–2.74, P =.002). Conclusion: Repeat hepatectomy for early recurrence was associated with worse overall survival and disease-free survival compared with late recurrence. These data may help inform patients and selection of patients being considered for repeat hepatectomy of recurrent hepatocellular carcinoma.
AB - Background: Repeat hepatectomy is a feasible treatment modality for intrahepatic recurrence after hepatectomy of hepatocellular carcinoma, yet the survival benefit remains ill-defined. The objective of the current study was to define long-term, oncologic outcomes after repeat hepatectomy among patients with early and late recurrence. Methods: Patients undergoing curative-intent repeat hepatectomy for recurrent hepatocellular carcinoma were identified using a multi-intuitional database. Early and late recurrence was defined by setting 1 year after initial hepatectomy as the cutoff value. Patient clinical characteristics, overall survival, and disease-free survival were compared among patients with early and late recurrence before and after propensity score matching. Results: Among all the patients, 81 had early recurrence and 129 had late recurrence from which 74 matched pairs were included in the propensity score matching analytic cohort. Before propensity score matching, 5-year overall survival and disease-free survival after resection of an early recurrence were 41.7% and 17.9%, respectively, which were worse compared with patients who had resection of a late recurrence (57.0% and 39.4%, both P <.01). After propensity score matching, 5-year overall survival and disease-free survival among patients with early recurrence were worse compared with patients with late recurrence (41.0% and 19.2% vs 64.3% and 43.2%, both P <.01). After adjustment for other confounding factors on multivariable Cox-regression analysis, early recurrence remained independently associated with decreased overall survival and disease-free survival (hazard ratio 2.22, 95% confidence interval 1.35–3.34, P =.001; hazard ratio 1.86, 95% confidence 1.26–2.74, P =.002). Conclusion: Repeat hepatectomy for early recurrence was associated with worse overall survival and disease-free survival compared with late recurrence. These data may help inform patients and selection of patients being considered for repeat hepatectomy of recurrent hepatocellular carcinoma.
UR - https://www.scopus.com/pages/publications/85076861682
U2 - 10.1016/j.surg.2019.11.005
DO - 10.1016/j.surg.2019.11.005
M3 - Article
C2 - 31879090
AN - SCOPUS:85076861682
SN - 0039-6060
VL - 169
SP - 911
EP - 920
JO - Surgery (United States)
JF - Surgery (United States)
IS - 4
ER -