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| Risk factors for early recurrence of small hepatocellular carcinoma after curative resection |
| Yan-Ming Zhou, Jia-Mei Yang, Bin Li, Zheng-Feng Yin, Feng Xu, Bin Wang, Wen Xu and Tong Kan |
Shanghai, China
Author Affiliations: Department of Hepato-Biliary-Pancreato-Vascular Surgery, First Xiamen Hospital, Fujian Medical University, Xiamen 361003, China (Zhou YM and Li B); Department of Special Treatment (Yang JM, Xu F and Kan T), Department of Molecular Oncology (Yin ZF and Xu W), Department of Pathology (Wang B), Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
Corresponding Author: Tong Kan, MD, Department of Special Treatment, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China (Tel: 86-21-25070808; Fax: 86-21-65562400; Email: kanto168.888@vip.163. com) |
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Abstract BACKGROUND: Poorer prognosis is seen in patients with hepatocellular carcinoma (HCC) after curative hepatic resection with early recurrence (≤1 year) than in those with late recurrence (>1 year). This study aimed to identify risk factors for postoperative early recurrence of small HCC (≤3 cm in diameter).
METHODS: The study population consisted of 158 patients who underwent curative resection for small HCC between January 2002 and July 2004. Risk factors for early recurrence were analyzed.
RESULTS: Thirty-three (20.8%) patients developed early recurrence after surgery. Univariate analysis showed the following significant risk factors for early recurrence in small HCC: serum alpha-fetoprotein (AFP) level >100 ng/ml, lack of tumor capsule formation, microscopic vascular invasion, high Edmonson-Steiner grades, and cytokeratin-19 (CK-19) expression (P<0.05). Multivariate stepwise logistic regression analysis showed that serum AFP level >100 ng/ml (odds ratio 2.561, 95% confidence interval 1.057 to 6.206, P=0.037) and microscopic vascular invasion (odds ratio 4.549, 95% confidence interval 1.865 to 11.097, P=0.001) were independent factors.
CONCLUSIONS: Postoperative early recurrence is related to serum AFP level >100 ng/ml and microscopic vascular invasion in patients with small HCC. Adjuvant therapy and careful follow-up are required for patients with these risk factors.
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2010, Vol. 9 
