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  • Steven Skipper posted an update 1 year, 4 months ago

    We excluded the early (<1?yr) death due to the definite other causes which were not related to recurrent tumor. The risk factor analysis for early (<1?yr) cancer-related death was performed with variables that included the preoperative data, histological findings of the explanted livers, and the patterns of recurrence. The univariate analysis of categorical variables was performed with the chi-square test or Fisher's exact test. Only variables that were determined to be statistically significant by the univariate analysis were used in the subsequent multivariate analysis, Apitolisib mw which used a logistic regression model with binary variables. The Kaplan�CMeier method with the log-rank test was used to calculate survival probabilities according to the initial site of recurrence and treatment method. The results are reported as hazard ratios (HR) with 95% confidence intervals. A p?<?0.05 was considered statistically significant in all analyses. This study was reviewed and approved by the institutional review board (No. 2011-10-016-001). The requirement for informed consent was waived due to the retrospective nature of the study. The characteristics of HCC recurrence after LT are shown in Table?2. Table?3 shows the follow-up results for HCC recurrence according to the initial recurrence site. The details of the treatments for recurrent lesions are summarized in the notes of Tables?2 and 3. Early recurrences (within six?months) were noted in 43% (27/63) of the patients, and the initial recurrence sites were the lungs only in 16% (10/63) patients, the liver only in 22% (14/63) patients, and multi-organ in 52% (33/63) patients. After investigating the extent of the recurrences, curative resections were possible in only 6% (4/63) patients. The proportion of patients with multiple-organ recurrences increased from 52% (33/63) to 71% (45/63) during the follow-up period (mean follow-up duration after recurrence: 16.9?��?17.1?months; range: 1.1�C86.6?months). The median survival time after HCC recurrence was 12?months (range: 1.1�C86.6?months). Overall survival curve and the survival curve according to the initial recurrence sites are shown in Fig.?1. Fig.?1A,B shows the survival after transplantation and the survival after the diagnosis of recurrence, respectively. The one-, two-, and three-yr survival rates of patients with recurrences only in the lung were 90%, 75%, and 45%, respectively, while the survival rates for patients with recurrences only in the liver were 71%, 50%, and 36%, respectively. In patients with recurrences in multiple organs, the one-, two-, and three-yr survival rates were 33%, 4%, and 0%, respectively (Fig.?1B). The survival of patients with recurrences in multiple organs was significantly lower in comparison to those with recurrences in the lung only (p?<?0.0001) and liver only (p?=?0.0002).