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Research Article
Chung Hwan Jun
Mokpo Hankook Hospital
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Extrahepatic recurrence (EHR) after curative hepatectomy for hepatocellular carcinoma (HCC) is associated with a poor prognosis. We investigated the features of EHR and identified its predictive factors.
Methods
This retrospective study included 398 treatment-naive patients who underwent curative hepatectomy for HCC at two tertiary hospitals. Multivariate analysis via Cox-regression was performed to identify the variables associated with EHR.
Results
EHR was diagnosed in 94 patients (23.6%) over a median follow-up period of 5.92 years, most commonly in the lungs (42.6%). The 5-/10-year cumulative rates of HCC recurrence and EHR were 63.0%/75.6% and 18.1%/35.0%, respectively.. The median time to EHR was 2.06 years. Intrahepatic HCC recurrence was not observed in 38.3% of patients on EHR diagnosis. On multivariate analysis, bile duct invasion, tumor necrosis, sum of tumor size > 7 cm, macrovascular invasion, first recurrence free survival < 1 year, and serum alpha fetoprotein > 400 IU/mL during recurrence were predictive of EHR. Four risk levels and their respective EHR were defined: very low risk, 2-/5-year, 0.7%/14.2%; low risk, 2-/5-year, 6.4%/31.0%; intermediate risk, 2-/5-year, 21.9%/73.1%; and high risk, 2-/3-year, 70.8%/100.0%.
Conclusion
Our predictive model clarifies the clinical course of EHR and could improve the follow-up strategy to improve outcomes.
Keywords
Extrahepatic recurrence (EHR), hepatocellular carcinoma (HCC)
Figure 1
Figure 2
Figure 3
No competing interests reported.
This is a list of supplementary files associated with this preprint. Click to download.
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CURRENT STATUS: Under Review
Version 1
Posted 25 Feb, 2021
No community comments so far
Editorial decision: Major revision
On 22 Feb, 2021
Reviews received
Received 17 Feb, 2021
Reviewers agreed
On 15 Feb, 2021
Reviewers invited
Invitations sent on 15 Feb, 2021
Editor assigned
On 15 Feb, 2021
Editor invited
On 15 Feb, 2021
Submission checks complete
On 15 Feb, 2021
First submitted
On 12 Feb, 2021
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A new preprint design is coming!
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This preprint is under consideration at Scientific Reports. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Chung Hwan Jun
Mokpo Hankook Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 25 Feb, 2021
No community comments so far
Editorial decision: Major revision
On 22 Feb, 2021
Reviews received
Received 17 Feb, 2021
Reviewers agreed
On 15 Feb, 2021
Reviewers invited
Invitations sent on 15 Feb, 2021
Editor assigned
On 15 Feb, 2021
Editor invited
On 15 Feb, 2021
Submission checks complete
On 15 Feb, 2021
First submitted
On 12 Feb, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Extrahepatic recurrence (EHR) after curative hepatectomy for hepatocellular carcinoma (HCC) is associated with a poor prognosis. We investigated the features of EHR and identified its predictive factors.
Methods
This retrospective study included 398 treatment-naive patients who underwent curative hepatectomy for HCC at two tertiary hospitals. Multivariate analysis via Cox-regression was performed to identify the variables associated with EHR.
Results
EHR was diagnosed in 94 patients (23.6%) over a median follow-up period of 5.92 years, most commonly in the lungs (42.6%). The 5-/10-year cumulative rates of HCC recurrence and EHR were 63.0%/75.6% and 18.1%/35.0%, respectively.. The median time to EHR was 2.06 years. Intrahepatic HCC recurrence was not observed in 38.3% of patients on EHR diagnosis. On multivariate analysis, bile duct invasion, tumor necrosis, sum of tumor size > 7 cm, macrovascular invasion, first recurrence free survival < 1 year, and serum alpha fetoprotein > 400 IU/mL during recurrence were predictive of EHR. Four risk levels and their respective EHR were defined: very low risk, 2-/5-year, 0.7%/14.2%; low risk, 2-/5-year, 6.4%/31.0%; intermediate risk, 2-/5-year, 21.9%/73.1%; and high risk, 2-/3-year, 70.8%/100.0%.
Conclusion
Our predictive model clarifies the clinical course of EHR and could improve the follow-up strategy to improve outcomes.
Figure 1
Figure 2
Figure 3
No competing interests reported.
This is a list of supplementary files associated with this preprint. Click to download.
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