This study verified whether radical treatment for hepatocellular carcinoma (HCC) oligo-recurrence after liver transplantation conveys survival benefits. A retrospective study of 144 patients with posttransplant HCC recurrence was performed. Propensity score matching was performed to adjust for baseline covariates between patients who received radical and palliative treatments. The primary endpoint was postrecurrence survival. A total of 50 patients (35%) received radical treatment for recurrence, and 76 (53%) and 18 (13%) patients received palliative and supportive treatments, respectively. Compared with the radical group, patients who received palliative treatment had more early recurrences (time from transplant 17 versus 11 months; P = 0.01) and more extensive disease in terms of tumor numbers (1 versus 4; P < 0.001), size of largest tumor (1.8 versus 2.5 cm; P = 0.046), numbers of involved organs (interquartile range [IQR], 1-1 versus 1-2; P = 0.02), and alpha-fetoprotein (AFP) level (7 versus 40 ng/mL; P = 0.01). Multivariate Cox regression analysis revealed that early recurrence (time from transplant hazard ratio [HR], 1.02; 95% confidence interval [CI], 1.01-1.03; P = 0.001), larger recurrent tumor (HR, 1.12; 95% CI, 1.03-1.23; P = 0.01), liver recurrence (HR, 1.84; 95% CI, 1.17-2.90; P = 0.01), and log₁₀AFP level at recurrence (HR, 1.27; 95% CI, 1.07-1.52; P = 0.01) predicted poor survival. Mammalian target of rapamycin inhibitor (HR, 0.331; 95% CI, 0.213-0.548; P < 0.001) and radical treatment (HR, 0.342; 95% CI, 0.213-0.548; P < 0.001) were associated with improved survival. After 2-to-1 propensity score matching for covariates, the 50 patients who received curative treatment survived significantly longer than the 25 matched patients who received palliative treatment (median survival time, 30.9 ± 2.4 versus 19.5 ± 3.0 months; P = 0.01). Radical treatment conveys survival benefits to HCC oligo-recurrence after liver transplantation.

中文翻译：

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验证根治性治疗在移植后肝细胞癌寡核苷酸复发中的益处：倾向评分分析

本研究验证了肝移植后肝细胞癌 (HCC) 寡聚复发的根治性治疗是否带来生存益处。对 144 名移植后 HCC 复发患者进行了回顾性研究。进行倾向评分匹配以调整接受根治性和姑息性治疗的患者之间的基线协变量。主要终点是复发后生存。共有 50 名患者 (35%) 因复发接受了根治性治疗，分别有 76 名 (53%) 和 18 名 (13%) 患者接受了姑息性和支持性治疗。与根治组相比，接受姑息治疗的患者有更多的早期复发（距移植 17 个月对 11 个月；P  = 0.01），并且在肿瘤数量方面疾病更广泛（1 对 4；P  < 0.001）、最大肿瘤的大小（1.8 对 2.5 cm；P  = 0.046）、受累器官数量（四分位数间距 [IQR]，1-1 对 1-2；P  = 0.02）和甲胎蛋白 (AFP ) 水平（7 对 40 ng/mL；P  = 0.01）。多变量 Cox 回归分析显示，早期复发（距移植时间风险比 [HR]，1.02；95% 置信区间 [CI]，1.01-1.03；P = 0.001），较大的复发 肿瘤（HR，1.12；95% CI，1.03 -1.23；P  = 0.01）、肝复发（HR，1.84；95% CI，1.17-2.90；P  = 0.01）和复发时的 log ₁₀ AFP 水平（HR，1.27；95% CI，1.07-1.52；P = 0.01) 预测生存率低。哺乳动物雷帕霉素抑制剂靶点（HR，0.331；95% CI，0.213-0.548；P  < 0.001）和根治性治疗（HR，0.342；95% CI，0.213-0.548；P  < 0.001）与生存率改善相关。在对协变量进行 2 比 1 倾向评分匹配后，接受根治性治疗的 50 名患者的生存时间明显长于接受姑息治疗的 25 名匹配患者（中位生存时间，30.9 ± 2.4 对 19.5 ± 3.0 个月；P = 0.01 ）  。根治性治疗为肝移植后 HCC 寡聚体复发带来生存益处。