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| Patients with early recurrence of hepatocellular carcinoma have poor prognosis |
| Tomoki Kobayashi, Hiroshi Aikata, Tsuyoshi Kobayashi, Hideki Ohdan, Koji Arihiro and Kazuaki Chayama |
Hiroshima, Japan
Author Affiliations: Department of Gastroenterology and Metabolism (Kobayashi To, Aikata H and Chayama K), and Department of Anatomical Pathology (Arihiro K), Hiroshima University Hospital, Hiroshima, Japan; Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences (Kobayashi Ts and Ohdan H), and Liver Research Project Center (Chayama K), Hiroshima University, Hiroshima, Japan
Corresponding Author: Hiroshi Aikata, MD, PhD, Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan (Tel: +81-82-257-5192; Fax: +81-82-257-5194; Email: aikata@hiroshima-u.ac.jp) |
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Abstract BACKGROUND: Early recurrence (ER) after hepatic resection (HR) is a poor prognostic factor for patients with hepatocellular carcinoma (HCC). This study aimed to identify the clinicopathological features, outcomes, and risk factors for ER after HR for small HCC in order to clarify the reasons why ER is a worse recurrence pattern.
METHODS: We retrospectively examined 130 patients who underwent HR for small HCC (≤30 mm). Recurrence was classified into ER (<2 years) and late recurrence (LR) (≥2 years). The clinicopathological features, outcomes, and risk factors for ER were analyzed by multivariate analysis.
RESULTS: ER was observed in 39 patients (30.0%). The survival rate of the ER group was significantly lower than that of the LR group (P<0.005), and ER was an independent prognostic factor for poor survival (P=0.0001). The ER group had a significantly higher frequency (P=0.0039) and shorter interval (P=0.027) of development to carcinoma beyond the Milan criteria (DBMC) compared with the LR group, and ER was an independent risk factor for DBMC (P<0.0001). Multi-nodularity, non-simple nodular type, and microvascular invasion were independent predictors for ER (P=0.012, 0.010, and 0.019, respectively).
CONCLUSIONS: ER was a highly malignant recurrence pattern associated with DBMC and subsequent poor survival after HR for small HCC. Multi-nodularity, non-simple nodular type, and microvascular invasion predict ER, and taking these factors into consideration may be useful for the decision of the treatment strategy for small HCC after HR.
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2017, Vol. 16 
