ArticleCancer management and research2026
Prognostic Determinants of Disease-Free Survival After Curative Resection for Hepatocellular Carcinoma: A Retrospective Cohort Study.
Article in Cancer management and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Hepatocellular carcinoma (HCC) is one of the three leading causes of cancer death worldwide today. It is most common in Asia. Liver resection is a curative treatment in the early stages. However, postoperative prognosis varies and data in Southeast Asia are still limited. Methods: This retrospective descriptive study included 295 patients with hepatocellular carcinoma who underwent curative intent resection at Viet Duc University Hospital between January 2015 and December 2024. Disease-free survival (DFS) was analyzed using the Kaplan-Meier method and compared with the Log rank test. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify prognostic factors. A nomogram integrating clinical and imaging features was constructed and evaluated using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA). Results: The median follow-up duration was 60.4 months (1-128 months). The DFS was 35.6 months. Multivariate analysis identified advanced TNM stage (III-IV) (HR 2.562, 95% CI 1.605-4.091, p<0.001), presence of microvascular invasion (HR 1.773, 95% CI 1.295-2.429, p<0.001), positive resection margin (R1) (HR 2.254, 95% CI 1.318-3.857, p=0.003) as independent predictors of poorer DFS, and Child-Pugh B (HR 2.319, 95% CI 1.234-4.356, p=0.009). A prognostic nomogram constructed from these tumor-related factors achieved a concordance index (C-index) of 0.64 (95% CI: 0.60-0.68). Time-dependent ROC analysis demonstrated area under the curve (AUC) values of 0.698, 0.678, and 0.682 at 1, 3, and 5 years, respectively, reflecting acceptable predictive accuracy and favorable calibration. Conclusion: Advanced tumor stage, microvascular invasion, and positive resection margins are key determinants of disease-free survival after curative resection for hepatocellular carcinoma. A nomogram derived from Vietnamese real-world data may facilitate individualized postoperative risk stratification and surveillance strategies.
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