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Prognostic Impact of the Pathologic Response of Patients with Hepatocellular Carcinoma After Preoperative Treatments
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Prognostic Impact of the Pathologic Response of Patients with Hepatocellular Carcinoma After Preoperative Treatments
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Journal Article
Prognostic Impact of the Pathologic Response of Patients with Hepatocellular Carcinoma After Preoperative Treatments
2025
Overview
Background
Hepatocellular carcinoma (HCC) exhibits varying degrees of tumor regression after preoperative treatments. However, the relationship between a tumor residual and its impact on recurrence-free survival (RFS) remains poorly defined. This study aimed to assess the effect of pathologic response on RFS in HCC patients undergoing preoperative treatments.
Methods
Data from 400 patients with HCC who received preoperative treatments were retrospectively analyzed. The correlation between tumor residual and RFS was assessed using the “surv_cutpoint” function in R software and further validated through Cox proportional hazards regression models, with the objective of identifying a cutoff value that was significantly associated with RFS.
Results
The overall analysis showed that pathologic response significantly influenced postoperative recurrence when tumor residual of 15% or less was detected. Multivariate regression analysis found that the independent risk factors for RFS were pathologic satellite nodules (hazard ratio [HR], 1.56; 95% confidence interval [CI] 1.05–2.25;
P
= 0.047), microvascular invasion (HR, 1.72; 95% CI 1.16–2.55
; P
= 0007), and advanced tumor stage (HR, 1.60; 95% CI 1.05–2.44;
P
= 0.031). In contrast, an independent protective factor affecting RFS was found to be residual of 15% or less (HR 0.41; 95% CI 0.26–0.63;
P
< 0.001). Subgroup analyses showed that RFS was significantly associated with a tumor residual cutoff value of 15% in Barcelona Clinic Liver Cancer (BCLC) stage A, 20% in stage BCLC stage B, and 26% in stage BCLC stage C.
Conclusions
This study demonstrated that achieving tumor residual of 15% or less after liver resection significantly reduces postoperative recurrence rates for HCC patients treated with preoperative therapies. The effect of tumor regression on RFS varied according to tumor stages.
Publisher
Springer International Publishing,Springer Nature B.V
Subject
/ Aged
/ Carcinoma, Hepatocellular - mortality
/ Carcinoma, Hepatocellular - pathology
/ Carcinoma, Hepatocellular - surgery
/ Carcinoma, Hepatocellular - therapy
/ Female
/ Humans
/ Kinases
/ Male
/ Medicine
/ Neoplasm Recurrence, Local - pathology
/ Neoplasm Recurrence, Local - therapy
/ Neoplasm, Residual - pathology
/ Oncology
/ Patients
/ Surgery
/ Tumors
