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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...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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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. |
format | Online Article Text |
id | pubmed-5993133 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
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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