Assessment of the Surveillance Interval at 1 Year after Curative Treatment in Hepatocellular Carcinoma: Risk Stratification

Guidelines recommend surveillance for hepatocellular carcinoma (HCC) recurrence at 3-month intervals during the first year after curative treatment and 6-month intervals thereafter in all patients. This strategy does not reflect individual risk of recurrence. We aimed to stratify risk of recurrence...

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Bibliographic Details
Published in:Gut and liver 2018, 12(5), , pp.571-582
Main Authors: Lee, Minjong, Chang, Young, Oh, Sohee, Cho, Young Youn, Jung, Dhong-Eun, Kim, Hong Hyun, Nam, Joon Yeul, Cho, Hyeki, Cho, Eun Ju, Lee, Jeong-Hoon, Yu, Su Jong, Yi, Nam-Joon, Lee, Kwang-Woong, Lee, Dong Ho, Lee, Jeong Min, Yoon, Jung-Hwan, Suh, Kyung-Suk, Kim, Yoon Jun
Format: Article
Language:English
Subjects:
Aged
carcinoma
Carcinoma, Hepatocellular - diagnosis
Carcinoma, Hepatocellular - surgery
curative treatment
Female
Hepatectomy - statistics & numerical data
hepatocellular
Humans
Liver Neoplasms - diagnosis
Liver Neoplasms - surgery
Male
Middle Aged
Neoplasm Recurrence, Local - diagnosis
Original
Population Surveillance - methods
Propensity Score
Proportional Hazards Models
Radiofrequency Ablation - statistics & numerical data
Retrospective Studies
Risk Assessment - methods
risk stratification
surveillance interval
Time Factors
내과학
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Summary:Guidelines recommend surveillance for hepatocellular carcinoma (HCC) recurrence at 3-month intervals during the first year after curative treatment and 6-month intervals thereafter in all patients. This strategy does not reflect individual risk of recurrence. We aimed to stratify risk of recurrence to optimize surveillance intervals 1 year after treatment. We retrospectively analyzed 1,316 HCC patients treated with resection/radiofrequency ablation at Barcelona Clinic Liver Cancer stage 0/A. In patients without 1-year recurrence under 3-monthly surveillance, a new model for recurrence was developed using backward elimination methods: training (n=582)/validation cohorts (n=291). Overall survival (OS) according to risk stratified by the new model was compared according to surveillance intervals: 3-monthly versus 6-monthly (n=401) after lead time bias correction and propensity-score matching analyses. Among patients without 1-year recurrence, age and international normalized ratio values were significant factors for recurrence (hazard ratio [HR], 1.03; 95% confidence interval [CI], 1.00 to 1.03; p=0.009 and HR, 5.63; 95% CI, 2.24 to 14.18; p
ISSN:1976-2283
2005-1212
DOI:10.5009/gnl17365