title: Factors influencing hepatocellular carcinoma prognosis after hepatectomy: a single-center experience.
abstract: OBJECTIVE
  Recurrence after hepatic resection is one of the most important factors impacting the prognosis and survival of patients with hepatocellular carcinoma (HCC). We identified prognostic factors affecting overall survival (OS) and disease-free survival (DFS) in patients with HCC after hepatic resection.
  
  
  METHODS
  This study was of a retrospective cohort design, and 126 patients who underwent hepatic resection for HCC at Gachon University Gil Medical Center between January 2005 and December 2010 were enrolled. Various clinical, laboratory, and pathological data were evaluated to determine the prognostic factors affecting OS and DFS.
  
  
  RESULTS
  Two- and 4-year OS and 2- and 4-year DFS were 78.1% and 65% and 51.1% and 26.6%, respectively. In a multivariate analysis, preoperative α-fetoprotein (> 400 ng/mL), tumor size (≥ 5 cm), multiple tumors (two or more nodules), presence of portal vein invasion, modified Union for International Cancer Control (UICC) stage III/IV, and Barcelona Clinic Liver Cancer (BCLC) stage B/C were independent prognostic factors affecting a shorter OS. In the multivariate analysis, presence of microvascular invasion, modified UICC stage III/IV, and BCLC stage B/C were independent prognostic factors for a shorter DFS.
  
  
  CONCLUSIONS
  The presence of vascular invasion was an independent poor prognostic factor for OS and DFS in patients with HCC after hepatic resection. Thus, close postoperative surveillance for early detection of recurrence and additional treatments are urgently needed in patients with vascular invasion after hepatic resection.
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Sung Keun
authors.initials: SK
authors.lastname: Park
authors.forename: Young Kul
authors.initials: YK
authors.lastname: Jung
authors.forename: Dong Hae
authors.initials: DH
authors.lastname: Chung
authors.forename: Keon Kuk
authors.initials: KK
authors.lastname: Kim
authors.forename: Yeon Ho
authors.initials: YH
authors.lastname: Park
authors.forename: Jung Nam
authors.initials: JN
authors.lastname: Lee
authors.forename: Oh Sang
authors.initials: OS
authors.lastname: Kwon
authors.forename: Yun Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Duck Joo
authors.initials: DJ
authors.lastname: Choi
authors.forename: Ju Hyun
authors.initials: JH
authors.lastname: Kim
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: C097353:AFP protein, human; D000509:alpha-Fetoproteins
keywords: Carcinoma, hepatocellular; Hepatic resection; Prognosis; Vascular invasion