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Long- versus short-interval follow-up after resection of hepatocellular carcinoma: a retrospective cohort study

BACKGROUND: Average postoperative follow-up intervals vary in patients undergoing hepatocellular carcinoma (HCC) resection because of limited evidence regarding the optimal interval. We aimed to compare the associations of long-versus short-interval follow-up with survival and recurrence in risk-str...

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Autores principales: He, Wei, Zheng, Yun, Zou, Ruhai, Shen, Jingxian, Yang, Junping, Qiu, Jiliang, Tao, Qiang, Liu, Wenwu, Yang, Zhiwen, Zhang, Yuanping, Li, Binkui, Yuan, Yunfei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5993133/
https://www.ncbi.nlm.nih.gov/pubmed/29784036
http://dx.doi.org/10.1186/s40880-018-0296-x
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author He, Wei
Zheng, Yun
Zou, Ruhai
Shen, Jingxian
Yang, Junping
Qiu, Jiliang
Tao, Qiang
Liu, Wenwu
Yang, Zhiwen
Zhang, Yuanping
Li, Binkui
Yuan, Yunfei
author_facet He, Wei
Zheng, Yun
Zou, Ruhai
Shen, Jingxian
Yang, Junping
Qiu, Jiliang
Tao, Qiang
Liu, Wenwu
Yang, Zhiwen
Zhang, Yuanping
Li, Binkui
Yuan, Yunfei
author_sort He, Wei
collection PubMed
description BACKGROUND: Average postoperative follow-up intervals vary in patients undergoing hepatocellular carcinoma (HCC) resection because of limited evidence regarding the optimal interval. We aimed to compare the associations of long-versus short-interval follow-up with survival and recurrence in risk-stratified HCC patients. METHODS: We performed a retrospective cohort study between 2007 and 2014. In total, 1227 patients treated by curative resection of Barcelona Clinic Liver Cancer stage A or B HCC were stratified as having a low (n = 865) or high (n = 362) risk of early recurrence (within the first 2 years after resection) based on prognostic factors identified by the least absolute shrinkage and selection operation algorithm. Patients were further classified into long-interval (every 4–6 months) and short-interval (every 2–4 months) follow-up subgroups based on follow-up within 2 years after resection (low risk, long vs. short: n = 390 vs. n = 475; high-risk, long vs. short: n = 149 vs. n = 213). RESULTS: The short-interval follow-up did not prolong overall survival in either the low-risk (hazard ratio [HR] = 1.152; 95% confidence interval [CI] 0.720–1.843) or high-risk (HR = 1.213; 95% CI 0.702–2.094) patients. Early recurrence occurred in 401 patients. For high-risk patients, the short-interval follow-up subgroup exhibited smaller intrahepatic recurrence than did the long-interval group (2.6 vs. 3.5 cm, respectively, P = 0.045). However, no significant difference in the rate of Barcelona Clinic Liver Cancer stage 0/A recurrence was found between the long- and short-interval follow-up groups in either low- or high-risk patients (63.1% vs. 68.2%, respectively, P = 0.580; 31.3% vs. 41.5%, respectively, P = 0.280). The rate of curative intent treatment for recurrence (34.5% vs. 39.7%, respectively, P = 0.430; 14.6% vs. 20.3%, respectively, P = 0.388) was also similar between the follow-up groups for low- and high-risk patients. CONCLUSIONS: Shortening the postoperative follow-up interval from every 4–6 months to every 2–4 months within the first 2 years after resection did not increase the rate of curative intent treatment or prolong the overall survival of patients with Barcelona Clinic Liver Cancer stage A or B HCC.
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spelling pubmed-59931332018-06-21 Long- versus short-interval follow-up after resection of hepatocellular carcinoma: a retrospective cohort study He, Wei Zheng, Yun Zou, Ruhai Shen, Jingxian Yang, Junping Qiu, Jiliang Tao, Qiang Liu, Wenwu Yang, Zhiwen Zhang, Yuanping Li, Binkui Yuan, Yunfei Cancer Commun (Lond) Original Article BACKGROUND: Average postoperative follow-up intervals vary in patients undergoing hepatocellular carcinoma (HCC) resection because of limited evidence regarding the optimal interval. We aimed to compare the associations of long-versus short-interval follow-up with survival and recurrence in risk-stratified HCC patients. METHODS: We performed a retrospective cohort study between 2007 and 2014. In total, 1227 patients treated by curative resection of Barcelona Clinic Liver Cancer stage A or B HCC were stratified as having a low (n = 865) or high (n = 362) risk of early recurrence (within the first 2 years after resection) based on prognostic factors identified by the least absolute shrinkage and selection operation algorithm. Patients were further classified into long-interval (every 4–6 months) and short-interval (every 2–4 months) follow-up subgroups based on follow-up within 2 years after resection (low risk, long vs. short: n = 390 vs. n = 475; high-risk, long vs. short: n = 149 vs. n = 213). RESULTS: The short-interval follow-up did not prolong overall survival in either the low-risk (hazard ratio [HR] = 1.152; 95% confidence interval [CI] 0.720–1.843) or high-risk (HR = 1.213; 95% CI 0.702–2.094) patients. Early recurrence occurred in 401 patients. For high-risk patients, the short-interval follow-up subgroup exhibited smaller intrahepatic recurrence than did the long-interval group (2.6 vs. 3.5 cm, respectively, P = 0.045). However, no significant difference in the rate of Barcelona Clinic Liver Cancer stage 0/A recurrence was found between the long- and short-interval follow-up groups in either low- or high-risk patients (63.1% vs. 68.2%, respectively, P = 0.580; 31.3% vs. 41.5%, respectively, P = 0.280). The rate of curative intent treatment for recurrence (34.5% vs. 39.7%, respectively, P = 0.430; 14.6% vs. 20.3%, respectively, P = 0.388) was also similar between the follow-up groups for low- and high-risk patients. CONCLUSIONS: Shortening the postoperative follow-up interval from every 4–6 months to every 2–4 months within the first 2 years after resection did not increase the rate of curative intent treatment or prolong the overall survival of patients with Barcelona Clinic Liver Cancer stage A or B HCC. BioMed Central 2018-05-21 /pmc/articles/PMC5993133/ /pubmed/29784036 http://dx.doi.org/10.1186/s40880-018-0296-x Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Article
He, Wei
Zheng, Yun
Zou, Ruhai
Shen, Jingxian
Yang, Junping
Qiu, Jiliang
Tao, Qiang
Liu, Wenwu
Yang, Zhiwen
Zhang, Yuanping
Li, Binkui
Yuan, Yunfei
Long- versus short-interval follow-up after resection of hepatocellular carcinoma: a retrospective cohort study
title Long- versus short-interval follow-up after resection of hepatocellular carcinoma: a retrospective cohort study
title_full Long- versus short-interval follow-up after resection of hepatocellular carcinoma: a retrospective cohort study
title_fullStr Long- versus short-interval follow-up after resection of hepatocellular carcinoma: a retrospective cohort study
title_full_unstemmed Long- versus short-interval follow-up after resection of hepatocellular carcinoma: a retrospective cohort study
title_short Long- versus short-interval follow-up after resection of hepatocellular carcinoma: a retrospective cohort study
title_sort long- versus short-interval follow-up after resection of hepatocellular carcinoma: a retrospective cohort study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5993133/
https://www.ncbi.nlm.nih.gov/pubmed/29784036
http://dx.doi.org/10.1186/s40880-018-0296-x
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