Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Liver Transplantation Center, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung, Taiwan.
Langenbecks Arch Surg. 2024 Aug 23;409(1):261. doi: 10.1007/s00423-024-03449-y.
Multiple studies have reported models for predicting early recurrence of hepatocellular carcinoma (HCC) after liver resection (LR). However, these models are too complex to use in daily practice. We aimed to develop a simple model.
We enrolled 1133 patients with newly diagnosed HCC undergoing LR. The Kaplan - Meier method and log-rank test were used for survival analysis and Cox proportional hazards analysis to identify prognostic factors associated with early recurrence (i.e., recurrence within two years after LR).
Early recurrence was identified in 403 (35.1%) patients. In multivariate analysis, alpha-fetoprotein (AFP) 20-399 vs. < 20 ng/ml (HR = 1.282 [95% confidence interval = 1.002-1.639]; p = 0.048); AFP ≥ 400 vs. < 20 ng/ml (HR = 1.755 [1.382-2.229]; p < 0.001); 7th edition American Joint Committee on Cancer (AJCC) stage 2 vs. 1 (HR = 1.958 [1.505-2.547]; p < 0.001); AJCC stage 3 vs. 1 (HR = 4.099 [3.043-5.520]; p < 0.001); and pathology-defined cirrhosis (HR = 1.46 [1.200-1.775]; p < 0.001) were associated with early recurrence. We constructed a predictive model with these variables, which provided three risk strata for recurrence-free survival (RFS): low risk, intermediate risk, and high risk, with two-year RFS of 79%, 57%, and 35%, respectively (p < 0.001).
We developed a simple model to predict early recurrence risk for patients undergoing LR for HCC.
多项研究已经报道了用于预测肝癌（HCC）患者肝切除术后早期复发的模型。然而，这些模型过于复杂，无法在日常实践中使用。我们旨在开发一种简单的模型。
我们纳入了 1133 例接受新诊断 HCC 肝切除术的患者。采用 Kaplan-Meier 方法和对数秩检验进行生存分析，Cox 比例风险分析确定与早期复发（即 LR 后 2 年内复发）相关的预后因素。
403 例（35.1%）患者发生早期复发。多变量分析中，甲胎蛋白（AFP）20-399ng/ml 与<20ng/ml（HR=1.282[95%置信区间 1.002-1.639]；p=0.048）；AFP≥400ng/ml 与<20ng/ml（HR=1.755[1.382-2.229]；p<0.001）；第 7 版美国癌症联合委员会（AJCC）分期 2 期与 1 期（HR=1.958[1.505-2.547]；p<0.001）；AJCC 分期 3 期与 1 期（HR=4.099[3.043-5.520]；p<0.001）；以及病理定义的肝硬化（HR=1.46[1.200-1.775]；p<0.001）与早期复发相关。我们使用这些变量构建了一个预测模型，该模型为无复发生存（RFS）提供了三个风险分层：低危、中危和高危，两年 RFS 分别为 79%、57%和 35%（p<0.001）。
我们开发了一种简单的模型，用于预测接受 HCC 肝切除术的患者的早期复发风险。
