Therapeutic efficacy and prognostic indicators in re-resection for recurrent hepatocellular carcinoma: Insights from a retrospective study

Qi Fan, MM; Pengcheng Wei, MM; Delin Ma, MD; Qian Cheng, MD; Jie Gao, MD; Jiye Zhu, MD; Zhao Li, MD

Surgery Open Science (Jan 2025)

Therapeutic efficacy and prognostic indicators in re-resection for recurrent hepatocellular carcinoma: Insights from a retrospective study

Qi Fan, MM,
Pengcheng Wei, MM,
Delin Ma, MD,
Qian Cheng, MD,
Jie Gao, MD,
Jiye Zhu, MD,
Zhao Li, MD

Affiliations

Qi Fan, MM: Department of General Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
Pengcheng Wei, MM: Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing, China; Beijing Key Surgical Basic Research Laboratory of Liver Cirrhosis and Liver Cancer, Beijing, China; Peking University Center of Liver Cancer Diagnosis and Treatment, Beijing, China
Delin Ma, MD: Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing, China; Beijing Key Surgical Basic Research Laboratory of Liver Cirrhosis and Liver Cancer, Beijing, China; Peking University Center of Liver Cancer Diagnosis and Treatment, Beijing, China
Qian Cheng, MD: Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing, China; Beijing Key Surgical Basic Research Laboratory of Liver Cirrhosis and Liver Cancer, Beijing, China; Peking University Center of Liver Cancer Diagnosis and Treatment, Beijing, China
Jie Gao, MD: Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing, China; Beijing Key Surgical Basic Research Laboratory of Liver Cirrhosis and Liver Cancer, Beijing, China; Peking University Center of Liver Cancer Diagnosis and Treatment, Beijing, China; Peking University Institute of Organ Transplantation, Beijing, China
Jiye Zhu, MD: Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing, China; Beijing Key Surgical Basic Research Laboratory of Liver Cirrhosis and Liver Cancer, Beijing, China; Peking University Center of Liver Cancer Diagnosis and Treatment, Beijing, China; Peking University Institute of Organ Transplantation, Beijing, China
Zhao Li, MD: Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing, China; Beijing Key Surgical Basic Research Laboratory of Liver Cirrhosis and Liver Cancer, Beijing, China; Peking University Center of Liver Cancer Diagnosis and Treatment, Beijing, China; Peking University Institute of Organ Transplantation, Beijing, China; Corresponding author at: Department of Hepatobiliary Surgery, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing 100044, China.

Journal volume & issue: Vol. 23
pp. 16 – 23

Abstract

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Aims: To evaluate the efficacy of re-resection in recurrent hepatocellular carcinoma (rHCC), identify prognostic factors, and provide clinical guidance. Methods: A retrospective analysis was conducted on 130 rHCC patients undergoing re-resection and 60 primary HCC patients undergoing initial hepatectomy at Peking University People's Hospital (2014–2022). Disease-free survival (DFS) and overall survival (OS) were compared. Prognostic factors were identified using univariate and multivariate COX regression analyses. Results: Baseline characteristics were comparable between groups (P > 0.05). DFS was similar between groups (30.8 vs. 32.2 months, P = 0.612). The 1-year, 2-year, and 3-year DFS rates for the re-resection group were 88.5 %, 64.9 %, and 56.7 %, respectively, versus 88.3 %, 65.0 %, and 53.3 % for the primary resection group. OS was lower in the re-resection group (36.1 vs. 47.2 months, P = 0.041) with 1-year, 2-year, and 3-year OS rates of 90.8 %, 73.1 %, and 60.0 %, compared to 95.0 %, 80.0 %, and 68.3 % for the primary resection group. Significant factors affecting DFS were Child-Pugh classification (P = 0.044), time to recurrence (P = 0.002), tumor differentiation (P = 0.044), and satellite nodules (P = 0.019). Factors influencing OS included Child-Pugh classification (P = 0.040), time to recurrence (P = 0.002), and tumor differentiation (P = 0.032). Conclusions: Re-resection is an effective treatment option for rHCC, with favorable outcomes as measured by DFS and OS, though OS is lower compared to initial hepatectomy. Key prognostic factors include Child-Pugh classification, time to recurrence, tumor differentiation, and satellite nodules.

Published in Surgery Open Science

ISSN: 2589-8450 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: https://www.journals.elsevier.com/surgery-open-science/

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