Prognostic factors of disease-free and overall survival in patients with hepatocellular carcinoma undergoing partial hepatectomy in curative intent.

PURPOSE: Tumor recurrence after liver resection continues to pose a major problem in hepatocellular carcinoma (HCC). Here we aimed to evaluate prognostic markers for disease-free (DFS) and overall survival (OS) in HCC-patients who underwent liver resection in curative intent. Additionally, we investigated the effects of HCC-recurrence in a subgroup of patients.

METHODS: Between 2010 and 2016, 111 patients underwent surgical resection for HCC at our institution. A subgroup of 50 patients showed tumor recurrence (n = 50) during follow-up. The associations of DFS and OS with histopathologic characteristics were assessed using univariable and multivariable Cox regression analyses.

RESULTS: Median DFS was 31 months and median OS was 27 months. Milan criteria (p = 0.045), macrovascular invasion (p = 0.044) and UICC tumor stage (p = 0.003) were independently associated with DFS while macrovascular invasion (p = 0.001) and MELD score (p = 0.010) were independently associated with OS. Tumor recurrence did not show an association with OS (p = 0.228). However, patients with HCC-recurrence who underwent repeat-surgical or interventional treatment showed improved OS compared to patients treated with palliative or sorafenib treatment alone (OS 18 months vs. 2 months; p < 0.001).

CONCLUSION: Tumor recurrence alone is not associated with poor oncological outcome and repeat liver resections as well as local-ablative procedures may help to improve OS in HCC.