title: Risk factors for recurrence after curative resection of hepatitis C-related hepatocellular carcinoma in patients without postoperative interferon therapy.
abstract: OBJECTIVE
  Hepatitis C (HC)-related hepatocellular carcinoma (HCC; HC-HCC) is highly recurrent.
  
  
  METHODS
  From 1995-2007, 183 curative hepatic resections for primary solitary HC-HCC without postoperative interferon therapy were included in this study. The patients were divided into three groups: (i) 2 cm or less (n = 56); (ii) more than 2 cm to less than 5 cm (n = 79); and (iii) 5 cm or more (n = 48). Independent risk factors for HC-HCC recurrence for each group were determined.
  
  
  RESULTS
  Independent risk factors for recurrence were aspartate aminotransferase or alanine aminotransferase (AST/ALT) of 80 IU/L or more (hazard ratio [HR], 2.1; P = 0.02) in patients with HCC of 2 cm or less, des-γ-carboxy prothrombin of 100 mAU/mL or more (HR, 2.5; P = 0.02) and AST/ALT of 80 IU/L or more (HR, 2.1; P = 0.04) in patients with HCC of more than 2 cm to less than 5 cm, and the presence of macroscopic portal vein tumor thrombus (HR, 2.8; P = 0.02) and AST/ALT of 80 IU/L or more (HR, 2.1; P = 0.04) in patients with HCC of 5 cm or more. All 13 late recurrences of 1 year or more after hepatic resection (27.1%) in patients with HCC of 5 cm or more were accompanied by AST/ALT of 80 IU/L or more.
  
  
  CONCLUSIONS
  AST/ALT of 80 IU/L or more is an independent risk factor for the recurrence of primary solitary HC-HCC after curative resection irrespective of the primary HC-HCC size.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima, Japan.
authors.forename: Yo-Ichi
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.forename: Takeo
authors.initials: T
authors.lastname: Toshima
authors.forename: Eiji
authors.initials: E
authors.lastname: Tsuijita
authors.forename: Kazuki
authors.initials: K
authors.lastname: Takeishi
authors.forename: Norifumi
authors.initials: N
authors.lastname: Harimoto
authors.forename: Toru
authors.initials: T
authors.lastname: Ikegami
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Yoshizumi
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ikeda
authors.forename: Yuji
authors.initials: Y
authors.lastname: Soejima
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
keywords: hepatitis C virus; hepatocellular carcinoma; risk factors; tumor recurrence