A model combining TNM stage and tumor size shows utility in predicting recurrence among patients with hepatocellular carcinoma after resection.

OBJECTIVE

Hepatocellular carcinoma (HCC) recurrence is a clinical challenge. An accurate prediction system for patients with HCC is needed, since the choice of HCC treatment strategies is very important.

PATIENTS AND METHODS

A total of 804 patients with HCC who underwent curative resection at Sun Yat-sen University Cancer Center were included in this study. Demographics, clinicopathological data, and follow-up information were collected.

RESULTS

A logistic regression analysis was conducted to investigate the relationships between clinical features and HCC recurrence. Tumor size (OR=1.454, 95% CI: 1.047-2.020, =0.026) and TNM stage (OR=1.360, 95% CI: 1.021-1.813, =0.036) were independent predictors of HCC recurrence after curative resection. Therefore, the following equation was established to predict HCC recurrence: 0.308×TNM+0.374×tumor size-0.639. The equation score was 0.53±0.23 in patients who experienced HCC recurrence compared with 0.47±0.24 in other patients. A similar trend was observed in patients who survived after the last follow-up, compared with those who did not, with scores of 0.37±0.26 vs 0.52±0.22, respectively (<0.001). The Kaplan-Meier analysis showed that patients with HCC with equation values >0.5 had significantly worse outcomes than those with equation values ≤0.5 (<0.001) for overall survival (OS) and recurrence (=0.043). Multivariate Cox analyses showed that tumor multiplicity (=0.039), involucrum (=0.029), vascular invasion (<0.001), and equation value (<0.001) were independent prognostic variables for OS, whereas tumor multiplicity (=0.01), tumor differentiation (=0.007), vascular invasion (<0.001), involucrum (=0.01), and equation value (<0.001) were independent prognostic variables for HCC recurrence.

CONCLUSION

We established a novel and effective equation for predicting the probability of recurrence and OS after curative resection. Patients with a high recurrence score, based on this equation, should undergo additional high-end imaging examinations.