A study conducted recently in Japan assessed the long-term prognostic factors in hepatocellular carcinoma (HCC) patients who survived more than 10 years after hepatectomy. The study also compared the prognostic factors between patients with recurrence who died and survived 10 years after initial hepatectomy.

The analysis included 35 HCC patients without recurrence over 10 years after hepatectomy, 48 patients with recurrence who survived over 10 years, and 132 patients who died within 10 years.

The rate of recurrence was found to be 16.3%, 10-year overall survival rate was 38.6%, and the 10-year recurrence-free survival (RFS) rate was 16.7%. Independent favorable factors for long-term RFS included nonviral, solitary tumor, well differentiation, and no severe fibrosis. High cholinesterase levels, small tumors and without portal vein invasion were independent favorable factors for long-term survival among patients with recurrence. Long-term survivors with recurrence had significantly low early recurrence, extrahepatic recurrence, multiple intrahepatic recurrences.

To conclude, major factors for long-term prognosis in HCC patients included a solitary tumor, small tumors, and no advanced fibrosis. Patients who relapse could survive long term in the setting of late or solitary intrahepatic recurrence, nonsevere cirrhosis, and curative treatment at recurrence.

Source: Shimada S, Kamiyama T, Orimo T, et al. Long-term prognostic factors of patients with hepatocellular carcinoma who survive over 10 years after hepatectomy. J Surg Oncol. 2020 Mar 20.