Nguyen Dinh Song

Abstract

Objectives: Evaluate prognostic factors for recurrence, disease-free survival (DFS), and overall survival (OS) in patients with newly diagnosed hepatocellular carcinoma (HCC) who underwent curative hepatectomy as first treatment at Cho Ray Hospital.

Methods: A retrospective study was performed on 2419 HCC patients who underwent primary curative hepatectomy as first treatment between January 2015 and December 2022. Patient follow-up extended to December 2024.

Results: The overall recurrence rate was 64.57%, with 1-, 2-, and 3-year recurrence rates of 45.9%, 55.5%, and 59.2%, respectively. The mean disease-free survival (DFS) was 22.4 months (median 9.8 months), and the mean overall survival (OS) was 40.9 months (median 30.3 months). Univariate analysis demonstrated statistically significant associations between recurrence, DFS, and OS with several factors, including gender, AFP level, vascular invasion, tumor number, tumor size, histological pattern, Edmondson-Steiner grade, removable metastatic lesions, and level of hepatectomy. Multivariate logistic regression identified gender, AFP level, vascular invasion, tumor number, tumor size, removable metastatic lesions, and Edmondson-Steiner grade as independent prognostic factors associated with recurrence. Multivariate Cox regression analysis revealed gender was an independent prognostic factor for DFS, whereas gender and tumor number as independent prognostic factors for OS.

Conclusion: Despite the high recurrence rate for 3 years, the 3-year survival outcomes remain favorable. Surgical resection continues to represent a promising and effective treatment option for patients with hepatocellular carcinoma.