title: Recurrence of hepatitis B-related hepatocellular carcinoma is associated with high viral load at the time of resection.
abstract: OBJECTIVE
  To identify the risk factors for recurrence of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after resection.
  
  
  METHODS
  Seventy-two patients who underwent liver resection for HBV-related HCC were recruited. Demographic, biochemical, tumor, and viral factors at the time of resection were evaluated by univariate and multivariate analyses to identify risk factors associated with recurrence after resection.
  
  
  RESULTS
  The median follow-up period was 18.9 months and the median age was 53 yr, with male-to-female ratio of 59:13. Age >60 yr, tumor size >5 cm, poorly differentiated tumor, lymphovascular permeation, the presence of microsatellite lesions, alpha-fetoprotein (AFP) level >1,000 ng/mL and HBV viral load >2,000 IU/mL (4 log(10) copies/mL) at the time of tumor resection, HBV genotype C, core promoter mutations, and patients with no antiviral treatment after tumor resection were associated with increased cumulative risk of HCC recurrence. By multivariate analysis, HBV viral load >2,000 IU/mL (4 log(10) copies/mL) (P= 0.001, odds ratio [OR] 22.3), AFP >1,000 ng/mL (P= 0.02, OR 7.4), tumor size >5 cm (P= 0.02, OR 5.1), and age >60 yr (P= 0.01, OR 4) at the time of tumor resection remained to be the independent risk factors.
  
  
  CONCLUSIONS
  Viral load of >2,000 IU/mL (4 log(10) copies/mL) is the most important correctable risk factor for HCC recurrence after resection. Whether antiviral therapy in these patients can decrease tumor recurrence requires further investigations.
authors.affiliation: Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors.forename: Ivan F N
authors.initials: IF
authors.lastname: Hung
authors.forename: Ronnie T P
authors.initials: RT
authors.lastname: Poon
authors.forename: Ching-Lung
authors.initials: CL
authors.lastname: Lai
authors.forename: James
authors.initials: J
authors.lastname: Fung
authors.forename: Sheung-Tat
authors.initials: ST
authors.lastname: Fan
authors.forename: Man-Fung
authors.initials: MF
authors.lastname: Yuen
mesh_terms: D000367:Age Factors; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000473:pathology / Q000601:surgery* / Q000821:virology*; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000150:complications*; D006515:Hepatitis B virus / Q000302:isolation & purification*; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology / Q000473:pathology / Q000601:surgery* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D012307:Risk Factors; D019562:Viral Load; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000509:alpha-Fetoproteins