Korean J Intern Med.  2013 Jul;28(4):428-438. 10.3904/kjim.2013.28.4.428.

Factors influencing hepatocellular carcinoma prognosis after hepatectomy: a single-center experience

• Park SK
• Jung YK
• Chung DH
• Kim KK
• Park YH
• Lee JN
• Kwon OS
• Kim YS
• Choi DJ
• Kim JH

• KMID: 1503780
• DOI: http://doi.org/10.3904/kjim.2013.28.4.428

Abstract

BACKGROUND/AIMS
Recurrence after hepatic resection is one of the most important factors impacting the prognosis and survival of patients with hepatocellular carcinoma (HCC). We identified prognostic factors affecting overall survival (OS) and disease-free survival (DFS) in patients with HCC after hepatic resection.
METHODS
This study was of a retrospective cohort design, and 126 patients who underwent hepatic resection for HCC at Gachon University Gil Medical Center between January 2005 and December 2010 were enrolled. Various clinical, laboratory, and pathological data were evaluated to determine the prognostic factors affecting OS and DFS.
RESULTS
Two- and 4-year OS and 2- and 4-year DFS were 78.1% and 65% and 51.1% and 26.6%, respectively. In a multivariate analysis, preoperative alpha-fetoprotein (> 400 ng/mL), tumor size (> or = 5 cm), multiple tumors (two or more nodules), presence of portal vein invasion, modified Union for International Cancer Control (UICC) stage III/IV, and Barcelona Clinic Liver Cancer (BCLC) stage B/C were independent prognostic factors affecting a shorter OS. In the multivariate analysis, presence of microvascular invasion, modified UICC stage III/IV, and BCLC stage B/C were independent prognostic factors for a shorter DFS.
CONCLUSIONS
The presence of vascular invasion was an independent poor prognostic factor for OS and DFS in patients with HCC after hepatic resection. Thus, close postoperative surveillance for early detection of recurrence and additional treatments are urgently needed in patients with vascular invasion after hepatic resection.

Keyword

Carcinoma, hepatocellular; Hepatic resection; Prognosis; Vascular invasion

MeSH Terms

Carcinoma, Hepatocellular/blood/mortality/secondary/*surgery
Disease-Free Survival
Female
*Hepatectomy/adverse effects/mortality
Humans
Kaplan-Meier Estimate
Liver Neoplasms/blood/mortality/pathology/*surgery
Male
Middle Aged
Multivariate Analysis
Neoplasm Invasiveness
Neoplasm Recurrence, Local
Neoplasm Staging
Proportional Hazards Models
Republic of Korea
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Tumor Burden
alpha-Fetoproteins/analysis
alpha-Fetoproteins