Hepatic function immediately after hepatectomy as a significant risk factor for early recurrence in hepatocellular carcinoma.
OBJECTIVE
The aim of this study was to clarify the significant risk factors as they relate to early recurrence after hepatectomy in cirrhotic patients with hepatocellular carcinoma (HCC).


METHODS
We retrospectively investigated 42 cirrhotic patients undergoing hepatectomy for a single HCC. We compared the clinicopathologic features of 14 patients with early intrahepatic recurrence (recurrence was detected within 1 year after hepatic resection; Group 1) with 28 patients without recurrence or with late intrahepatic recurrence (recurrence was confirmed more than 1 year after hepatic resection; Group 2).


RESULTS
There were no significant differences in the pre-operative and intra-operative clinical background data or pathological data between the 2 groups. Regarding recurrence pattern, although not significant, the incidence of intrahepatic metastasis in Group 1 (85.7%) was higher than in Group 2 (50.0%). Maximum values of total bilirubin and albumin within 7 days after hepatectomy for patients in Group 2 were significantly better than those in Group 1. Aspatate aminotransferase (AST) and alanine aminotransferase (ALT) immediately after hepatectomy in Group 1 were also higher than in Group 2, although statistically insignificant. The overall 1-year and 3-year survival rates between Group 1 versus Group 2 were 85.7% versus 100% (p < 0.01) and 57.2% versus 90.0% (p < 0.01), respectively.


CONCLUSIONS
Hepatic functional damage immediately after hepatectomy is as significant risk factor for early intrahepatic recurrence in cirrhotic HCC. Careful perioperative management of hepatic function may therefore be important in preventing early recurrence and prolonging survival.
Hanazaki
K
K
Department of Surgery, Nagano Red Cross Hospital, Japan.
Wakabayashi
M
M
Sodeyama
H
H
Kajikawa
S
S
Amano
J
J
D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D001663:Bilirubin / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000150:complications / Q000401:mortality / Q000601:surgery; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000097:blood* / Q000150:complications / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism*; D015996:Survival Rate
D014408:Biomarkers, Tumor; D012709:Serum Albumin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin