Hsu Heng-Yuan, Tang Jui-Hsiang, Huang Song-Fong, Huang Chun-Wei, Lin Sey-En, Huang Shu-Wei, Lee Chao-Wei, Wu Tsung-Han, Yu Ming-Chin
Department of Surgery, New Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City 23652, Taiwan.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, New Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City 23652, Taiwan.
Biomedicines. 2024 Mar 14;12(3):655. doi: 10.3390/biomedicines12030655.
The perioperative outcomes of a partial hepatectomy for hepatocellular carcinoma (HCC) have improved. However, high recurrence rates after a curative hepatectomy for HCC is still an issue. This study aimed to analyze the difference between various recurrence patterns.
We retrospectively reviewed 754 patients with HCC who underwent a curative hepatectomy between January 2012 and March 2021. Patients with recurrent events were categorized into three types: regional recurrence (type I), multiple intrahepatic recurrence (type II), or presence of any distant metastasis (type III).
The median follow-up period was 51.2 months. Regarding recurrence, 375 (49.7%) patients developed recurrence, with 244 (32.4%), 51 (6.8%), and 80 (10.6%) patients having type I, II, and III recurrence, respectively. Type III recurrence appeared to be more common in male patients and those with major liver resection, vascular invasion, a large tumor size (>5 cm), a higher tumor grade, and higher levels of AST and AFP ( < 0.05). Patients who had distant metastasis at recurrence had the shortest recurrence time and the worst overall survival ( < 0.001 and < 0.001).
our study demonstrated that recurrence with distant metastasis occurred earliest and had the worst outcome compared to regional or multiple intrahepatic recurrences.
肝细胞癌（HCC）肝部分切除术的围手术期结局已有所改善。然而，HCC根治性肝切除术后的高复发率仍是一个问题。本研究旨在分析不同复发模式之间的差异。
我们回顾性分析了2012年1月至2021年3月期间接受根治性肝切除术的754例HCC患者。复发事件患者分为三种类型：区域复发（I型）、多发肝内复发（II型）或存在任何远处转移（III型）。
中位随访期为51.2个月。关于复发，375例（49.7%）患者出现复发，其中I型、II型和III型复发患者分别为244例（32.4%）、51例（6.8%）和80例（10.6%）。III型复发在男性患者以及接受大范围肝切除、有血管侵犯、肿瘤较大（>5 cm）、肿瘤分级较高、AST和AFP水平较高的患者中似乎更为常见（<0.05）。复发时发生远处转移的患者复发时间最短，总生存期最差（<0.001和<0.001）。
我们的研究表明，与区域复发或多发肝内复发相比，伴有远处转移的复发发生最早，结局最差。
