Published 2023
| Version v1
Publication
Predictors of non-transplantable recurrence in hepatocellular carcinoma patients treated with frontline liver resection
Creators
- Pelizzaro, Filippo
- Trevisani, Franco
- Simeon, Vittorio
- Vitale, Alessandro
- Cillo, Umberto
- Piscaglia, Fabio
- Missale, Gabriele
- Sangiovanni, Angelo
- Foschi, Francesco G
- Cabibbo, Giuseppe
- Caturelli, Eugenio
- Di Marco, Maria
- Azzaroli, Francesco
- Brunetto, Maurizia R
- Raimondo, Giovanni
- Vidili, Gianpaolo
- Guarino, Maria
- Gasbarrini, Antonio
- Campani, Claudia
- Svegliati-Baroni, Gianluca
- Giannini, Edoardo G
- Mega, Andrea
- Masotto, Alberto
- Rapaccini, Gian Ludovico
- Magalotti, Donatella
- Sacco, Rodolfo
- Nardone, Gerardo
- Farinati, Fabio
Contributors
Others:
- Pelizzaro, Filippo
- Trevisani, Franco
- Simeon, Vittorio
- Vitale, Alessandro
- Cillo, Umberto
- Piscaglia, Fabio
- Missale, Gabriele
- Sangiovanni, Angelo
- Foschi, Francesco G
- Cabibbo, Giuseppe
- Caturelli, Eugenio
- Di Marco, Maria
- Azzaroli, Francesco
- Brunetto, Maurizia R
- Raimondo, Giovanni
- Vidili, Gianpaolo
- Guarino, Maria
- Gasbarrini, Antonio
- Campani, Claudia
- Svegliati-Baroni, Gianluca
- Giannini, Edoardo G
- Mega, Andrea
- Masotto, Alberto
- Rapaccini, Gian Ludovico
- Magalotti, Donatella
- Sacco, Rodolfo
- Nardone, Gerardo
- Farinati, Fabio
Description
Background and Aims: Hepatocellular carcinoma (HCC) recurrence is common in patients treated with liver resection (LR). In this study, we aimed to evaluate the incidence and preoperative predictors of non-transplantable recurrence in patients with single HCC <= 5 cm treated with frontline LR.Methods: From the Italian Liver Cancer (ITA. LI.CA) database, 512 patients receiving frontline LR for single HCC <= 5 cm were retrieved. Incidence and predictors of recurrence beyond Milan criteria (MC) and up-to- seven criteria were compared between patients with HCC <4 and >= 4 cm.Results: During a median follow-up of 4.2 years, the overall recurrence rate was 55.9%. In the >= 4 cm group, a significantly higher proportion of patients recurred beyond MC at first recurrence (28.9% vs. 14.1%; p < 0.001) and overall (44.4% vs. 25.2%; p < 0.001). Similar results were found considering recurrence beyond up-to-seven criteria. Compared to those with larger tumours, patients with HCC <4 cm had a longer recurrence-free survival and overall survival. HCC size >= 4 cm and high alpha-fetoprotein (AFP) level at the time of LR were independent predictors of recurrence beyond MC (and up-to-seven criteria). In the subgroup of patients with available histologic information (n = 354), microvascular invasion and microsatellite lesions were identified as additional independent risk factors for non-transplantable recurrence.Conclusions: Despite the high recurrence rate, LR for single HCC <= 5 cm offers excellent long-term survival. Non-transplantable recurrence is predicted by HCC size and AFP levels, among pre- operatively available variables. High-risk patients could be considered for frontline LT or listed for transplantation even before recurrence.
Additional details
Identifiers
- URL
- https://hdl.handle.net/11567/1155555
- URN
- urn:oai:iris.unige.it:11567/1155555
Origin repository
- Origin repository
- UNIGE