Conditional Survival Analysis Demonstrates that Recurrence Risk of Surgically Treated Hepatocellular Carcinoma Evolves with Time

摘要

Abstract Objective The study aim was to investigate long-term change in tumor recurrence risk in patients with hepatocellular carcinoma (HCC) after hepatic resection. Recurrence probability over time was estimated by conditional survival (CS) analysis. Patients and Methods Early-stage HCC patients with hepatic resection were selected for inclusion from our surgery database. Variables predictive of tumor recurrence were identified by univariate and multivariate analyses. Five-year recurrence-free CS probability was calculated for all patients and for risk groups stratified by independent predictors. Results In this series of 436 patients, tumor size 5?cm, microvascular invasion, positive resection margin, liver cirrhosis, and a indocyanine green retention ratio at 15?min (ICG-R15) 20% were independently predictive of tumor recurrence. The estimated 5-year recurrence-free CS probability improved with each additional year of recurrence-free survival, and the improvement was significantly greater in the high-risk than in the low- or intermediate-risk groups. Conclusion CS provides added value during follow-up of early-stage HCC patients treated by surgical resection. ]]>