Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 28, 2022; 28(36): 5351-5363
Published online Sep 28, 2022. doi: 10.3748/wjg.v28.i36.5351
Early extrahepatic recurrence as a pivotal factor for survival after hepatocellular carcinoma resection: A 15-year observational study
Jae Hyun Yoon, Sung Kyu Choi, Sung Bum Cho, Hee Joon Kim, Yang Seok Ko, Chung Hwan Jun
Jae Hyun Yoon, Sung Kyu Choi, Department of Gastroenterology and Hepatology, Chonnam National University Hospital and College of Medicine, Gwangju 61469, South Korea
Sung Bum Cho, Department of Gastroenterology and Hepatology, Hwasun Chonnam National University Hospital and College of Medicine, Hwasun 58128, South Korea
Hee Joon Kim, Department of Surgery, Chonnam National University Hospital and College of Medicine, Gwangju 61469, South Korea
Yang Seok Ko, Department of Surgery, Hwasun Chonnam National University Hospital and College of Medicine, Hwasun 58128, South Korea
Chung Hwan Jun, Department of Internal Medicine, Mokpo Hankook Hospital, Mokpo 58643, South Korea
Author contributions: Yoon JH wrote the manuscript; Choi SK, Cho SB, and Jun CH designed the concept of the study; Yoon JH, Kim HJ, and Ko YS collected and analyzed the data on baseline patient characteristics and recurrence of HCC; Yoon JH interpreted the data; Choi SK, Cho SB, and Jun CH supervised the project.
Supported by Research Supporting Program of the Korean Association for the Study of the Liver and the Korean Liver Foundation, No. KASLKLF2019-06; and Chonnam National University Hospital Biomedical Research Institute, No. BCRI121007.
Institutional review board statement: This study was approved by the Institutional Review Board of Chonnam National University Hospital (IRB No. CNUH-2019-203).
Informed consent statement: Owing to the retrospective design of our study and the use of de-identified data, the requirement for informed consent was waived under the approval of the Institutional Review Board of Chonnam National University Hospital.
Conflict-of-interest statement: The authors declare no competing interests.
Data sharing statement: Data available on additional request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sung Kyu Choi, MD, PhD, Professor, Department of Gastroenterology and Hepatology, Chonnam National University Hospital and College of Medicine, Jebongroe 42, Gwangju 61469, South Korea. choisk@jnu.ac.kr
Received: May 11, 2022
Peer-review started: May 11, 2022
First decision: August 1, 2022
Revised: August 11, 2022
Accepted: September 8, 2022
Article in press: September 8, 2022
Published online: September 28, 2022
Core Tip

Core Tip: Surgical resection of hepatocellular carcinoma is effective and curative treatment modality. However, early extrahepatic recurrence (EHR) after resection is related to poor prognosis. This study indicates the close correlation between the early EHR and survival outcome (hazard ratio 6.77, 95% confidence interval 4.81-9.52). The time to EHR was 8.8 mo and in 52.7% of early EHR group, EHR occurred as the first recurrence. On multivariate analysis, serum albumin < 4.0 g/dL, serum alkaline phosphatase > 100 U/L, surgical margin involvement, venous and/or lymphatic involvement, satellite nodules, tumor necrosis, tumor size ≥ 7 cm, and macrovascular invasion were associated risk factors with early EHR.