Page 385 - Read Online

Sempokuya et al. Hepatoma Res 2019;5:38 Hepatoma Research
DOI: 10.20517/2394-5079.2019.013

Original Article Open Access

Ten-year survival and recurrence of hepatocellular
cancer

Tomoki Sempokuya , Linda L. Wong
1,2
3
1 Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, HI 96813 , USA.
2 Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, NE 68198, USA.
3 Department of Surgery, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, HI 96813 , USA.
Correspondence to: Linda L. Wong, Department of Surgery, John A. Burns School of Medicine, University of Hawaii at Manoa,
Honolulu, Hawaii 550 South Beretania St., Suite 403, Honolulu, Hawaii, HI 96813, USA. E-mail: hepatoma@aol.com
How to cite this article: Sempokuya T, Wong LL. Ten-year survival and recurrence of hepatocellular cancer. Hepatoma Res
2019;5:38. http://dx.doi.org/10.20517/2394-5079.2019.013
Received: 9 Sep 2019 First Decision: 29 Sep 2019 Revised: 7 Oct 2019 Accepted: 8 Oct 2019 Published: 13 Oct 2019

Science Editor: Dalbir Sandhu Copy Editor: Rong-Rong Dou Production Editor: Jing Yu

Abstract
Received: First Decision: Revised: Accepted: Published:
Aim: Long-term survival after hepatocellular cancer (HCC) is difficult to achieve likely related to recurrence. This
Science Editor: Copy Editor: Production Editor: Jing Yu study aimed to identify factors that were predictive of 10-year survival after the diagnosis of HCC.

Methods: In a prospectively collected database of 1374 HCC cases (1993-2019), we identified 70 patients who
survived over 10 years regardless of treatment. We then identified 164 patients in the entire cohort who either had
liver resection or transplant, and died before 10 years. Demographics, tumor characteristics, treatment, recurrence
and treatment of recurrence were compared.

Results: Of the 10-year survivors, 36 underwent transplant, 27 had liver resection and 7 patients had only locoregional
therapy. Compared to the non-survivors, the 10-year survivors were younger and had fewer comorbidities or
recurrence, smaller tumor size, lower AST, ALT, AFP, platelets, neutrophil-to-lymphocyte ratio. Multivariate analysis
showed only age and diabetes to be negative predictors. Recurrence occurred in 24 survivors (34.3%) with mean
time to recurrence with standard deviation 57.1 ± 42.6 months compared to 80 non-survivors (48.7%) with mean
time to recurrence of 15.3 ± 14.8 months. For hepatic resection, 10-year survivors had longer time to recurrence
compared to non-survivors (median: 31.3 months).

Conclusion: Long-term survivors mostly occur after resection or transplant, but 10% of our cohort survived 10 years
with only locoregional therapy. Underlying health status maybe an important predictor of 10-year survival for

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as 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.

www.hrjournal.net