Analysis of survival in very early hepatocellular carcinoma after resection.
GOALS, BACKGROUND: The Barcelona-Clinic-Liver-Cancer staging system recommended liver resection only for patients with "very early stage HCC." Liver transplantation was suggested for patients with "early stage HCC" without associated diseases when liver transplantation is always associated with organ shortage. We hypothesized that patients with early hepatocellular carcinoma (HCC) might have comparable survival rate as that with the very early HCC after the surgical treatment if they were spared from early recurrence (ER) defined as tumor recurrence within 1 year after the curative resection. The aim of this study was to validate this hypothesis and to identify preoperative risk factors for ER in early HCC patients after the surgical resection.


METHODS
The medical records of 194 patients, who underwent surgical resection of HCC, were retrospectively reviewed. One hundred eighty-two patients with either very early or early HCC were included in the final analysis.


RESULTS
The overall survival (OS) rate of very early HCC was significantly longer than that of early HCC after the surgery. However, if the patients with ER were removed, there was no statistically significant difference in OS rate between very early and early HCC where the 3 years OS rates were 91.3 and 86.1%, respectively (P=0.451). Cox proportional hazard model showed that HCC nodule with hyperattenuation in arterial phase, and which lack encapsulation had a risk of ER.


CONCLUSIONS
Early HCC without hyperattenuation on arterial phase and with tumor encapsulation might be expected to have comparable outcome with very early HCC after the surgical resection.
Division of Gastroenterology, Department of Internal Medicine, Inha University School of Medicine, Jung-Gu, Incheon, Korea.
Jung I L
JI
Lee
Jin Woo
JW
Lee
Young Soo
YS
Kim
Yun Ah
YA
Choi
Yong Sun
YS
Jeon
Soon Gu
SG
Cho
D000328:Adult; D000368:Aged; 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; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome