title: Risk factors and outcome of early recurrence after resection of small hepatocellular carcinomas.
abstract: BACKGROUND
  This study aimed to clarify risk factors for early recurrence and examine the subsequent outcome in patients undergoing potentially R0 resection of small hepatocellular carcinomas (HCCs) (<or=2 cm in greatest dimension).
  
  
  METHODS
  Eighty-nine patients were divided into 2 groups as follows: 26 patients suffering from recurrence within 2 years of surgery (early recurrence group) and 63 patients who were disease-free for at least 2 years (disease-free 2Y group).
  
  
  RESULTS
  Only 7 of 63 patients (11%) from the group that was disease-free for at least 2 years died during the 5-year period after surgery, whereas 13 of 26 patients (50%) from the early recurrence group died. Multivariate analysis showed that the preoperative maximum removal rate of technetium-99m-diethylenetriamine pentaacetic acid-galactosyl human serum albumin and microscopic vascular invasion were independent predictors of the early recurrence of small HCC.
  
  
  CONCLUSIONS
  Early recurrence of small HCC is the leading cause of death within 5 years after R0 resection. The preoperative hepatic functional reserve influences early recurrence, even in patients with small tumors.
authors.affiliation: Department of Surgery, Hirakata Hospital, Kansai Medical University, Hirakata, Osaka, Japan. kaibori@hirakata.kmu.ac.jp
authors.forename: Masaki
authors.initials: M
authors.lastname: Kaibori
authors.forename: Morihiko
authors.initials: M
authors.lastname: Ishizaki
authors.forename: Takamichi
authors.initials: T
authors.lastname: Saito
authors.forename: Kosuke
authors.initials: K
authors.lastname: Matsui
authors.forename: A-Hon
authors.initials: AH
authors.lastname: Kwon
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Kamiyama
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011184:Postoperative Period; D011379:Prognosis; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed