Hepatitis viral status affects the pattern of intrahepatic recurrence after resection for hepatocellular carcinoma.
OBJECTIVE
To define whether the patterns of intrahepatic recurrence after resection for hepatocellular carcinoma differ according to hepatitis viral status.


METHODS
One hundred and eleven patients undergoing a curative resection for hepatocellular carcinoma were divided into three groups: the C-viral group (n=55), which tested positive for hepatitis C antibody; the B-viral group (n=32), which tested positive for hepatitis B surface antigen; and the non-B non-C (NBNC) group (n=24), which tested negative for both hepatitis B surface antigen and hepatitis C antibody. The long-term outcomes were analyzed retrospectively.


RESULTS
The pattern of development of intrahepatic recurrence differed between the NBNC group and the other groups: the cumulative probability of intrahepatic recurrence reached a plateau at 2.4 years after resection in the NBNC group, while it continued to increase steadily in the hepatitis viral groups. The C-viral group showed a higher incidence of intrahepatic recurrence than the other groups by univariate (P=0.0306) and multivariate (relative risk=1.69, P=0.0429) analyses. Multiple intrahepatic recurrent lesions were more common in the C-viral group (P=0.0457).


CONCLUSIONS
Multicentric carcinogenesis in the remnant liver was less common in the NBNC group than in hepatitis viral groups. Hepatitis C virus infection is a significant risk factor for intrahepatic recurrence after resection and is also associated with multiple intrahepatic recurrent lesions.
Wakai
T
T
Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Shirai
Y
Y
Yokoyama
N
N
Nagakura
S
S
Hatakeyama
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D006528:Carcinoma, Hepatocellular / Q000601:surgery / Q000821:virology*; D016009:Chi-Square Distribution; D005260:Female; D006509:Hepatitis B / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D016751:Hepatitis E / Q000150:complications*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D016019:Survival Analysis