Landmark analysis of the risk of recurrence after resection or ablation for HCC: A nationwide study.

IF 5.6 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Hepatology Communications Pub Date : 2024-06-19 eCollection Date: 2024-07-01 DOI:10.1097/HC9.0000000000000472

Frederik Kraglund, Nikolaj Skou, Gerda Elisabeth Villadsen, Peter Jepsen

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引用次数: 0

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

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肝癌切除或消融术后复发风险的标志性分析：一项全国性研究。

背景：自初次治疗以来，HCC 在特定地标复发的风险尚不清楚。通过这项基于登记的研究，我们旨在对 HCC 切除术或消融术后的预后进行细致的描述，包括地标分析：我们利用丹麦全国范围内的医疗登记资料，确定了 2000-2018 年间接受切除或消融术作为首次 HCC 治疗的所有患者。HCC复发被定义为首次治疗后90天内再次接受HCC治疗。我们对复发和死亡的累积风险进行了竞争风险地标分析：在 4801 名 HCC 患者中，我们发现 426 名患者接受了切除术，544 名患者接受了消融术。两组患者的肝硬化发生率和肿瘤分期不同。切除术后的5年复发风险为40.7%（95% CI：35.5%-45.8%），消融术后的5年复发风险为60.7%（95% CI：55.9%-65.1%）。1年复发风险从切除时的20.4%（95% CI：16.6%-24.6%）下降到5年时的4.7%（95% CI：0.9%-13.9%）。消融术的风险从治疗时的 36.1%（95% CI：31.9%-40.4%）下降到 5 年后的 5.3%（95% CI：0.4%-21.4%）。在切除术和消融术后，无复发死亡的风险在各阶段均保持稳定：总之，自治疗之日起，HCC切除术或消融术后复发或死亡的风险很高，但随着生存期的延长，复发风险大大降低。这些信息对临床医生和患者都很有价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hepatology Communications GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

8.00

自引率

2.00%

发文量

248

审稿时长

8 weeks

期刊介绍： Hepatology Communications is a peer-reviewed, online-only, open access journal for fast dissemination of high quality basic, translational, and clinical research in hepatology. Hepatology Communications maintains high standard and rigorous peer review. Because of its open access nature, authors retain the copyright to their works, all articles are immediately available and free to read and share, and it is fully compliant with funder and institutional mandates. The journal is committed to fast publication and author satisfaction.