Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan.
Eur J Surg Oncol. 2023 Aug;49(8):1444-1449. doi: 10.1016/j.ejso.2023.03.211. Epub 2023 Mar 17.
The updated Barcelona Clinic Liver Cancer guidelines recommend liver resection (LR) for patients with single hepatocellular carcinoma (HCC) of any size. This study developed a preoperative model for predicting early recurrence in patients undergoing LR for single HCC.
We identified 773 patients undergoing LR for single HCC between 2011 and 2017 from the cancer registry database of our institution. Multivariate Cox regression analyses were performed to construct a preoperative model for predicting early recurrence, i.e., recurrence within 2 years of LR.
Early recurrence was identified in 219 patients (28.3%). The final model of early recurrence included four predictive factors-alpha-fetoprotein level of ≥20 ng/mL, tumor size of >30 mm, Model for End-Stage Liver Disease score of >8, and cirrhosis. Preoperative application of this model provided three risk strata for recurrence-free survival (RFS): low risk, with 2-year RFS of 79.8% (95% confidence interval [CI]: 75.7-84.2%); intermediate risk, with 2-year RFS of 66.6% (95% CI: 61.1-72.6%); and high risk, with 2-year RFS of 51.1% (95% CI: 43.0-60.8%).
We developed a preoperative model for predicting early recurrence after LR for single HCC. This model provides useful information for clinical decision-making.
巴塞罗那临床肝癌指南更新版建议对任何大小的单发肝细胞癌（HCC）患者行肝切除术（LR）。本研究旨在建立一个预测接受单发 HCC 行 LR 治疗患者早期复发的术前模型。
我们从本机构的癌症登记数据库中确定了 2011 年至 2017 年间接受 LR 治疗的 773 例单发 HCC 患者。采用多变量 Cox 回归分析构建用于预测早期复发（LR 后 2 年内复发）的术前模型。
219 例（28.3%）患者发生早期复发。早期复发的最终模型包括 4 个预测因素：甲胎蛋白水平≥20ng/mL、肿瘤直径>30mm、终末期肝病模型评分>8 分和肝硬化。该模型术前应用可为无复发生存率（RFS）提供 3 个风险分层：低危组 2 年 RFS 为 79.8%（95%CI：75.7-84.2%）、中危组 2 年 RFS 为 66.6%（95%CI：61.1-72.6%）和高危组 2 年 RFS 为 51.1%（95%CI：43.0-60.8%）。
我们建立了一个预测单发 HCC 行 LR 后早期复发的术前模型。该模型为临床决策提供了有用的信息。
