Risk factors of intrahepatic recurrence after curative resection of hepatocellular carcinoma.
OBJECTIVE
Although the risk factors for the development of intrahepatic recurrence after hepatectomy for hepatocellular carcinoma (HCC) have been widely studied, little attention has been given to the prognostic factors affecting such patients.


METHODS
Intrahepatic recurrence occurred in 105 (56%) of 188 patients who underwent curative hepatic resection of HCC and were discharged from the hospital. Among them, 17 (16%) also had simultaneous extrahepatic recurrence. Independent prognostic factors were evaluated by multivariate analysis using Cox's proportional hazards model.


RESULTS
Multivariate analysis revealed that presence of extrahepatic recurrence, hepatitis B, and non-surgical treatments for recurrence were independent predictors of poor overall survival after initial hepatic resection or after recurrence. Risk factors of extrahepatic recurrence were young age, solitary and large HCC, high hepatitis activity, and large amount of intraoperative blood loss and blood transfusion.


CONCLUSIONS
Survival of patients with intrahepatic recurrent HCC after resection should be stratified by the type of recurrence, type of hepatitis, and type of treatment for recurrence.
Hanazaki
Kazuhiro
K
Second Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan. hanayan@hsp.md.shinshu-u.ac.jp
Matsushita
Akimasa
A
Nakagawa
Kan
K
Misawa
Ryosuke
R
Amano
Jun
J
D000368:Aged; D000375:Aging; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D016063:Blood Loss, Surgical; D006528:Carcinoma, Hepatocellular / Q000201:enzymology / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000473:pathology / Q000503:physiopathology; D008113:Liver Neoplasms / Q000201:enzymology / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis; D065227:Transfusion Reaction
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase