Risk factors for early recurrence after surgical resection for hepatocellular carcinoma.
10.3350/kjhep.2008.14.3.371
- Author:
Ui Jun PARK
1
;
Yong Hoon KIM
;
Koo Jeong KANG
;
Tae Jin LIM
Author Information
1. Department of Surgery, Keimyung University, School of Medicine, Daegu, Korea. kjkang@dsmc.or.kr
- Publication Type:Original Article ; Comparative Study ; English Abstract
- Keywords:
Carcinoma, Hepatocellular;
Hepatectomy;
Recurrence;
Risk Factor
- MeSH:
Adult;
Aged;
Carcinoma, Hepatocellular/etiology/mortality/*surgery;
Female;
Humans;
Liver Neoplasms/etiology/mortality/*surgery;
Male;
Middle Aged;
Multivariate Analysis;
Neoplasm Invasiveness;
Neoplasm Recurrence, Local/*epidemiology;
Neoplasm Staging;
Predictive Value of Tests;
Retrospective Studies;
Risk Factors;
Survival Rate;
Time Factors;
alpha-Fetoproteins/analysis
- From:The Korean Journal of Hepatology
2008;14(3):371-380
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Early recurrence (ER) after liver resection is one of the most important factors impacting the prognosis and survival of patients with hepatocellular carcinoma (HCC). This study aimed to identify the factors associated with ER after curative hepatic resection for HCC. METHODS: From the July 2000 to July 2006, 144 patients underwent hepatic resection for HCC at a single institution. After excluding those with ruptured HCC, combined or mixed HCC, and who died during admission, 116 patients were analyzed. Patients with ER (defined as within 1 year) were compared with those who remained free of disease for more than 1 year. Various clinical characteristics including tumor and operative factors were evaluated to determine the factors predicting postoperative ER using univariate and multivariate analyses. RESULTS: ER occurred in 51 patients (44%). In the univariate analysis, tumor size (P=0.001), microvascular invasion (P=0.003), portal vein invasion (P=0.001), TNM stage (P=0.010), serum levels of alpha-fetoprotein (AFP) (P=0.002) and aspartate aminotransferase (AST) (P=0.011), and operative time (P=0.033) were significantly associated with ER. AFP and AST were the independent predictors of ER in the multivariate analysis (P<0.05). CONCLUSIONS: Preoperative serum AFP and AST levels were the independent risk factors for ER after surgical resection for HCC. Close postoperative surveillance is recommended for early detection of recurrence and additional treatments in patients with these factors.