Introduction Cirrhosis is deemed to be a contributing factor to the postoperative recurrence of hepatocellular carcinoma (HCC); however, the precise impact of liver fibrosis on both cancer-specific prognoses remains unclear. This investigation sought to elucidate the effect of liver fibrosis severity on the cancer-specific prognosis. Methods A total of 524 consecutive patients were included. Recurrence-free survival (RFS) and disease-specific survival (DSS) were compared according to fibrosis stage. Moreover, postoperative outcomes were subjected to analysis in cohorts of patients with F0 and F1-3, as well as in those with F1-3 and F4, who were carefully matched for background factors. Results The 5-year RFS exhibited a significantly worse outcome in the F4 group compared to other stages of fibrosis: 5-year RFS - F0 (46.6%), F1-3 (33.1%), and F4 (23.5%), p = 0.03 (F0 vs. F1-3) and p < 0.01 (F1-3 vs. F4). Additionally, the 5-year DSS also presented a significantly worse prognosis in the F4 group: 5-year DSS - F0 (82.9%), F1-3 (73.6%), and F4 (57.4%), p = 0.04 (F0 vs. F1-3) and p < 0.01 (F1-3 vs. F4). In multivariate analysis, fibrosis 1, 2, 3, and 4 stage (compared with F0) (HR: 1.70, 1.81, 1.89, and 3.99, 95% confidence interval: 1.10-1.99, 1.39-2.22, 1.41-2.55, and 2.25-5.01, p = 0.022, p = 0.008, p < 0.001, and p < 0.001, respectively) was independent risk factor for RFS. After matched analysis, both RFS and DSS exhibited significantly worse prognoses in the presence of more advanced fibrosis. There was a significantly higher incidence of multiple recurrences in the F4 group than the F1-3 group, and a number of recurrences were observed both in the same hepatic segment as the resected side and in the contralateral lobe in F4 group. Discussion/Conclusion The hazard and recurrence pattern of HCC signifies that the prognosis could potentially be poor, as the hepatic fibrosis likely owing to a higher hepatocarcinogenic potential, even in the absence of progression to cirrhotic condition. The risk of de novo recurrence may also increase with the progression of this fibrosis.

中文翻译：

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肝纤维化严重程度对肝细胞癌肿瘤学预后的影响。


简介 肝硬化被认为​​是肝细胞癌 (HCC) 术后复发的一个因素；然而，肝纤维化对两种癌症特异性预后的确切影响仍不清楚。这项研究旨在阐明肝纤维化严重程度对癌症特异性预后的影响。方法 总共纳入 524 名连续患者。根据纤维化阶段比较无复发生存期（RFS）和疾病特异性生存期（DSS）。此外，对 F0 和 F1-3 以及 F1-3 和 F4 患者队列的术后结果进行了分析，这些患者的背景因素经过仔细匹配。结果 与其他纤维化阶段相比，F4 组的 5 年 RFS 结果明显较差：5 年 RFS - F0 (46.6%)、F1-3 (33.1%) 和 F4 (23.5%)，p = 0.03（F0 与 F1-3）且 p < 0.01（F1-3 与 F4）。此外，F4 组的 5 年 DSS 预后也明显较差：5 年 DSS - F0 (82.9%)、F1-3 (73.6%) 和 F4 (57.4%)，p = 0.04（F0 与.F1-3) 且 p < 0.01（F1-3 与 F4）。多变量分析中，纤维化1、2、3、4期（与F0相比）（HR：1.70、1.81、1.89、3.99，95%置信区间：1.10-1.99、1.39-2.22、1.41-2.55、2.25 -5.01、p = 0.022、p = 0.008、p < 0.001 和 p < 0.001）是 RFS 的独立危险因素。经过匹配分析后，在存在更严重的纤维化的情况下，RFS 和 DSS 均表现出明显更差的预后。 F4组多次复发的发生率显着高于F1-3组，且F4组的切除侧同肝段和对侧肝叶均出现多次复发。 讨论/结论 HCC 的危险和复发模式表明预后可能较差，因为即使没有进展为肝硬化，肝纤维化也可能是由于较高的肝癌可能性所致。随着纤维化的进展，从头复发的风险也可能增加。