title: Relationship between period of survival and clinicopathological characteristics in patients with hepatocellular carcinoma who underwent hepatectomy.
abstract: 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.
authors.affiliation: 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
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nanashima
authors.forename: Takafumi
authors.initials: T
authors.lastname: Abo
authors.forename: Syuuichi
authors.initials: S
authors.lastname: Tobinaga
authors.forename: Masaki
authors.initials: M
authors.lastname: Kunizaki
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Hidaka
authors.forename: Takashi
authors.initials: T
authors.lastname: Nonaka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Miuma
authors.forename: Naota
authors.initials: N
authors.lastname: Taura
authors.forename: Hisamitsu
authors.initials: H
authors.lastname: Miyaaki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakashima
authors.forename: Terumitsu
authors.initials: T
authors.lastname: Sawai
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakao
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
mesh_terms: 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
chemical_list: D015415:Biomarkers; D011498:Protein Precursors; D000509:alpha-Fetoproteins; C008208:acarboxyprothrombin; D011516:Prothrombin