Risk factors for early recurrence of HBV-related hepatocellular carcinoma meeting milan criteria after curative resection.
BACKGROUND
The prognosis of patients with hepatocellular carcinoma (HCC) after curative resection varies greatly. Few studies had investigated the risk factors for early recurrence (recurrence-free time ≤ 1 year) of hepatitis B virus (HBV)-related HCCs meeting Milan criteria.


METHODS
A retrospective analysis was performed on the 224 patients with HCC meeting Milan criteria who underwent curative liver resection in our center between February 2007 and March 2012. The overall survival (OS) rate, recurrence-free survival (RFS) rate and risk factors for early recurrence were analyzed.


RESULTS
After a median follow-up of 33.3 months, HCC reoccurred in 105 of 224 patients and 32 died during the period. The 1-, 3- and 5-year OS rates were 97.3%, 81.6% and 75.6% respectively, and the 1-, 3- and 5-year RFS rates were 73.2%, 53.7% and 41.6%. Cox regression showed alpha-fetoprotein (AFP) > 800 ng/ml (HR 2.538, 95% CI 1.464-4.401, P=0.001), multiple tumors (HR 2.286, 95% CI 1.123-4.246, P=0.009) and microvascular invasion (HR 2.518, 95% CI 1.475-4.298, P=0.001) to be associated with early recurrence (recurrence-free time ≤ 1-year) of HCC meeting Milan criteria.


CONCLUSIONS
AFP > 800 ng/ml, multiple tumors and microvascular invasion are independent risk factors affecting early postoperative recurrence of HCC. In addition resection appears capable of replacing liver transplantation in some situations with safety and a better outcome.
Liver Transplantation Center, Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China E-mail : ccwentianfu@sohu.com.
Wen-Jiang
WJ
Zhu
Chu-Ying
CY
Huang
Chuan
C
Li
Wei
W
Peng
Tian-Fu
TF
Wen
Lv-Nan
LN
Yan
Bo
B
Li
Wen-Tao
WT
Wang
Ming-Qing
MQ
Xu
Jia-Yin
JY
Yang
Li
L
Jiang
D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000473:pathology / Q000601:surgery / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000009:adverse effects*; D006509:Hepatitis B / Q000150:complications* / Q000473:pathology / Q000601:surgery / Q000821:virology; D006515:Hepatitis B virus / Q000472:pathogenicity; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery / Q000821:virology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D000509:alpha-Fetoproteins / Q000032:analysis
D000509:alpha-Fetoproteins