Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus N, Denmark.
Department of Radiology, Aarhus University Hospital, Aarhus N, Denmark.
Hepatol Commun. 2024 Jun 19;8(7). doi: 10.1097/HC9.0000000000000472. eCollection 2024 Jul 1.
The risk of HCC recurrence at particular landmarks since the initial treatment is unknown. With this registry-based study, we aimed to provide a nuanced description of the prognosis following resection or ablation for HCC, including landmark analyses.
Using the Danish nationwide health care registries, we identified all patients who received resection or ablation in 2000-2018 as the first HCC treatment. HCC recurrence was defined as a new HCC treatment > 90 days after the first treatment. We conducted competing risk landmark analyses of the cumulative risk of recurrence and death.
Among 4801 patients with HCC, we identified 426 patients who received resection and 544 who received ablation. The 2 treatment cohorts differed in cirrhosis prevalence and tumor stage. The 5-year recurrence risk was 40.7% (95% CI 35.5%-45.8%) following resection and 60.7% (95% CI: 55.9%-65.1%) following ablation. The 1-year recurrence risk decreased over the landmarks from 20.4% (95% CI: 16.6%-24.6%) at the time of resection to 4.7% (95% CI: 0.9%-13.9%) at the 5-year landmark. For ablation, the risk decreased from 36.1% (95% CI: 31.9%-40.4%) at the time of treatment to 5.3% (95% CI: 0.4%-21.4%) at the 5-year landmark. The risk of death without recurrence was stable over the landmarks following both resection and ablation.
In conclusion, the risk of recurrence or death following resection or ablation for HCC is high from the treatment date, but the risk of recurrence decreases greatly over the survival landmarks. This information is valuable for clinicians and their patients.
自初始治疗以来，特定时间点 HCC 复发的风险尚不清楚。本基于登记的研究旨在提供 HCC 患者接受切除术或消融术后的预后情况的详细描述，包括对时间点的分析。
我们使用丹麦全国卫生保健登记处，确定了所有在 2000-2018 年间接受切除术或消融术作为首次 HCC 治疗的患者。HCC 复发定义为首次治疗后 > 90 天的新 HCC 治疗。我们对复发和死亡的累积风险进行了竞争风险时间点分析。
在 4801 例 HCC 患者中，我们确定了 426 例接受切除术和 544 例接受消融术的患者。这两个治疗组在肝硬化患病率和肿瘤分期方面存在差异。切除术和消融术后 5 年的复发风险分别为 40.7%（95%CI：35.5%-45.8%）和 60.7%（95%CI：55.9%-65.1%）。切除术后的 1 年复发风险随时间点而降低，从治疗时的 20.4%（95%CI：16.6%-24.6%）降至 5 年时间点的 4.7%（95%CI：0.9%-13.9%）。对于消融术，风险从治疗时的 36.1%（95%CI：31.9%-40.4%）降至 5 年时间点的 5.3%（95%CI：0.4%-21.4%）。切除术后和消融术后，无复发的死亡风险在时间点上保持稳定。
总之，HCC 患者接受切除术或消融术治疗后，复发或死亡的风险从治疗之日起很高，但随着生存时间点的推移，复发风险会大大降低。这些信息对临床医生及其患者具有重要价值。
