Smoking as a Risk Factor for Very Late Recurrence in Surgically Resected Early-Stage Primary Hepatocellular Carcinoma

Wei-Ru Cho; Chih-Chi Wang; Mu-Jung Tsai; Chih-Che Lin; Yi-Hao Yen; Chien Hung Chen; Yuan-Hung Kuo; Chih-Chien Yao; Chao-Hung Hung; Pao-Yuan Huang; An-Che Liu; Ming-Chao Tsai

doi:10.1177/11795549241228232

Smoking as a Risk Factor for Very Late Recurrence in Surgically Resected Early-Stage Primary Hepatocellular Carcinoma

Clin Med Insights Oncol. 2024 Mar 5:18:11795549241228232. doi: 10.1177/11795549241228232. eCollection 2024.

Authors

Wei-Ru Cho¹, Chih-Chi Wang², Mu-Jung Tsai³, Chih-Che Lin², Yi-Hao Yen⁴, Chien Hung Chen⁴, Yuan-Hung Kuo⁴, Chih-Chien Yao⁴, Chao-Hung Hung⁴, Pao-Yuan Huang⁴, An-Che Liu⁴, Ming-Chao Tsai^{4

5}

Affiliations

¹ Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital, Yunlin.
² Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung.
³ Kaohsiung Municipal Kaohsiung Senior High School, Kaohsiung.
⁴ Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung.
⁵ School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung.

Abstract

Background: The risk of first recurrence of hepatocellular carcinoma (HCC) within years 5 to 10 after curative hepatectomy remains unknown. We aimed to assess the incidence and prognostic factors for very late recurrence among patients who achieved 5 years' recurrence-free survival (RFS) after primary resection.

Methods: We retrospectively analyzed 337 patients with early-stage HCC underwent primary tumor resection and achieved more than 5 years' RFS.

Results: A total of 77 patients (22.8%) developed very late recurrence. The cumulative very late recurrence rate increased from 6.9% and 11.7% to 16.6% at 6, 7, and 8 years, respectively. Patients stopped smoking had a higher rate of very late RFS.

Conclusions: The high rates of very late recurrence in HCC indicate that patients warrant continued surveillance, even after 5 recurrence-free years. Moreover, smoking is a risk factor for very late HCC recurrence, and quitting smoking may reduce the risk of very late recurrence.

Keywords: Hepatocellular carcinoma; long-term; recurrence; smoking.