Sex Differences in Early and Late Recurrence after Liver Resection of Hepatocellular Carcinoma (A Multicenter Study from China) = Sex Differences in Early and Late Recurrence after Liver Resection of Hepatocellular Carcinoma (A Multicenter Study from China)

다국어 초록 (Multilingual Abstract)

Aims: There is a striking sex difference in the incidence of hepatocellular carcinoma (HCC), with a strong predominance for males. However, the impact of sex on the incidence of recurrence after curative resection of HCC remains controversial. Herein, we assess sex differences in the risks of recurrence and mortality for patients undergone curative resection of HCC.
Methods: Data from 1,435 HCC patients undergone curative resection (1,228 males and 207 females) between 2004 and 2014 at five institutions in China were retrospectively analyzed. Patients’ baseline characteristics, operative variables, and rates of early recurrence (≤ 2 years after resection), late recurrence (> 2 years) and cancer-specific mortality (CSM) were evaluated and compared. Multivariable competing-risks regression analyses were performed to identify predictors associated with CSM, early and late recurrence.
Results: The early recurrence rates between males and females were similar (43.3% vs. 42.0%, P=0.728), but the late recurrence and CSM rates in males were higher when compared to females (17.2% vs. 11.2%, P=0.044; 42.8% vs. 34.3%, P=0.022). Multivariable competing-risks regression analyses revealed no sex difference in early recurrence; however, males had significantly higher late recurrence rate [hazard ratio (HR), 1.752; 95% CI, 1.145-2.682; P=0.010] and CSM rate (HR, 1.307; 95% CI, 1.015-1.683; P=0.038) than females.
Conclusions: Males had significantly higher late recurrence and CSM rates after curative resection of HCC than females. This suggests postoperative surveillance for HCC recurrence be varied by sex, especially for patients without recurrence at 2 years after resection.