Relationship between period of survival and clinicopathological characteristics in patients with hepatocellular carcinoma who underwent hepatectomy.
OBJECTIVE
Cancer death in the early period after hepatectomy remains problematic in patients with hepatocellular carcinoma (HCC). We examined the relationship between clinicopathological parameters' and survival periods in 234 HCC patients who underwent hepatectomy.


METHODS
Patients were divided into four groups: Group 1, survival > 5 years; Group 2, survival for 2-5 years; Group 3, cancer death at 2-5 years; and Group 4, cancer death in < 2 years.


RESULTS
Numbers of patients in each subgroup were: Group 1, n = 87 (37%); Group 2, n = 44 (19%); Group 3, n = 46 (20%); and Group 4, n = 57 (24%). Child-Pugh B status, blood loss > 1500 ml, multiple tumors, tumor size > 5 cm, not meeting Milan criteria, irregular macroscopic findings, invasion of Glissonian pedicle, invasion of hepatic vein, higher modified Japan Integrated Staging score (3-5), long-term ascites after hepatectomy and postoperative tumor recurrence within 12 months were frequent in Group 4 ( p < 0.05). Multivariate analysis revealed AFP level > or = 1000 ng/ml (hazard ratio (HR), 2.6) and early tumor relapse (HR, 8.1) as independently related parameters ( p < 0.05).


CONCLUSIONS
Careful follow-up for early tumor relapse may be important for improving postoperative outcomes in HCC patients with high preoperative AFP levels.
Nanashima
Atsushi
A
Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. a-nanasm@net.nagasaki-u.ac.jp
Abo
Takafumi
T
Tobinaga
Syuuichi
S
Kunizaki
Masaki
M
Hidaka
Shigekazu
S
Nonaka
Takashi
T
Miuma
Satoshi
S
Taura
Naota
N
Miyaaki
Hisamitsu
H
Nakashima
Masahiro
M
Sawai
Terumitsu
T
Nakao
Kazuhiko
K
Nagayasu
Takeshi
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D011498:Protein Precursors / Q000097:blood; D011516:Prothrombin; D015996:Survival Rate; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000032:analysis
D015415:Biomarkers; D011498:Protein Precursors; D000509:alpha-Fetoproteins; C008208:acarboxyprothrombin; D011516:Prothrombin