Risk factors for early recurrence of small hepatocellular carcinoma after curative resection.
BACKGROUND
Poorer prognosis is seen in patients with hepatocellular carcinoma (HCC) after curative hepatic resection with early recurrence (<or=1 year) than in those with late recurrence (>1 year). This study aimed to identify risk factors for postoperative early recurrence of small HCC (<or=3 cm in diameter).


METHODS
The study population consisted of 158 patients who underwent curative resection for small HCC between January 2002 and July 2004. Risk factors for early recurrence were analyzed.


RESULTS
Thirty-three (20.8%) patients developed early recurrence after surgery. Univariate analysis showed the following significant risk factors for early recurrence in small HCC: serum alpha-fetoprotein (AFP) level >100 ng/ml, lack of tumor capsule formation, microscopic vascular invasion, high Edmonson-Steiner grades, and cytokeratin-19 (CK-19) expression (P<0.05). Multivariate stepwise logistic regression analysis showed that serum AFP level >100 ng/ml (odds ratio 2.561, 95% confidence interval 1.057 to 6.206, P=0.037) and microscopic vascular invasion (odds ratio 4.549, 95% confidence interval 1.865 to 11.097, P=0.001) were independent factors.


CONCLUSIONS
Postoperative early recurrence is related to serum AFP level >100 ng/ml and microscopic vascular invasion in patients with small HCC. Adjuvant therapy and careful follow-up are required for patients with these risk factors.
Zhou
Yan-Ming
YM
Department of Hepato-Biliary-Pancreato-Vascular Surgery, First Xiamen Hospital, Fujian Medical University, Xiamen 361003, China.
Yang
Jia-Mei
JM
Li
Bin
B
Yin
Zheng-Feng
ZF
Xu
Feng
F
Wang
Bin
B
Xu
Wen
W
Kan
Tong
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053539:Keratin-19 / Q000097:blood; D008099:Liver / Q000098:blood supply; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D009389:Neovascularization, Pathologic / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D000509:alpha-Fetoproteins / Q000378:metabolism
D014408:Biomarkers, Tumor; D053539:Keratin-19; D000509:alpha-Fetoproteins