Risk Factors of Early Recurrenec after Curative Hepatic Resection for Hepatocellular Carcinoma

Choi, Jae Hun; Rho, Helen; Koh, Young Taeg; Suh, Kyung Suk; Lee, Kuhn Uk

Abstract

PURPOSE: The purpose of this study was to clarify the risk factors of early recurrence within 1 year by comparing them with patients without recurrence within 3 years after curative liver resection in hepatocellular carcinoma (HCC).
MATERIALS AND METHODS
Three hundred and twenty six patients with HCC who underwent curative liver resection between 1991 Jan, to 1995 June were observed for possible recurrence for least 3 years. These patients were divided into two groups: 79 patients who had recurrence within 1 years (early recurred group) and 132 patients who had no recurrence within 3 years (no recurred group).
RESULTS
Overall survival rates in 5 years after 1iver resection were 17.5% in early recurred group and 94.9% in no recuned group. Risk factors of early recurrence in multivariate analysis were the presence of liver cirrhosis in nontumorous parenchyme (p=0.011, relative risk (RR)=2.5), tumor size (p=0.004, RR 2.9), multiple mass (p 0.015, RR=3.4), the presence of angioinvasion (p=0.043, RR=3.7), serum alpha-fetoprotein more than 20 ng/dl (p=0.007, RR=2.7), major liver resection more than lobectomy (p=0.039, RR=3.2). However, other factors such as age, sex, preoperative transcatheter arterial embolization (TAE), several liver function tests, Child classification, reseetion margin, total necrosis of tumor after preoperative TAE, tumor encapsulation, histologic type, Edmondsons grade, were not significant in our study.
CONCLUSION
The risk factors of early recurrence were liver cirrhosis, tumor size, number of tumor, angioinvasion, serum alpha-fetoprotein, and major liver resection. Biologic characteristics of tumor were the most important risk factors of early recurrence. Because the extent of liver resection is the only risk factor that depends on surgeons decision, we must consider this factor in liver resection for HCC.