Histological subclassification of cirrhosis can predict recurrence after curative resection of hepatocellular carcinoma.
BACKGROUND
Recurrence of hepatocellular carcinoma (HCC) after curative resection continues to be a major cause of death. This prospective study is designed to investigate whether histological subclassification of cirrhosis using the Laennec system could predict recurrence in patients with hepatitis B virus (HBV)-related HCC after curative resection.


METHODS
Patients with HBV-related HCC who underwent curative resection and showed Laennec stage 3 to 4 were enrolled and the cases with stage 4 were subclassified histologically into three groups (stages 4A, 4B and 4C) according to the Laennec system. Between February 2006 and August 2009, 92 patients were recruited.


RESULTS
Stage 3, 4A, 4B and 4C were identified in 24 (26.1%), 15 (16.3%), 43 (46.7%) and 10 (10.9%) patients respectively. The cumulative incidence rates of recurrence at 1, 2 and 3 years were 24.2%, 40.5% and 55.1% respectively. On multivariate analysis, serum albumin [hazard ratio (HR), 0.528; 95% confidence interval (CI), 0.312-0.891; P=0.017] and Edmondson-Steiner grade III-IV (HR, 3.456; 95% CI, 1.123-10.517; P=0.031) were significantly correlated with early recurrence (<1 year), whereas stage 4C (HR, 5.426; 95% CI, 1.030-28.598; P=0.046) was the only independent risk factor for late recurrence (≥1 year).


CONCLUSIONS
Histological subclassification of cirrhosis using the Laennec system is a significant predictor of late recurrence in patients with HBV-related HCC after curative resection.
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea; Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea; Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea.
Seung Up
SU
Kim
Kyu Sik
KS
Jung
Sarah
S
Lee
Jun Yong
JY
Park
Do Young
DY
Kim
Sang Hoon
SH
Ahn
Gi Hong
GH
Choi
Kyung Sik
KS
Kim
Jin Sub
JS
Choi
Kwang-Hyub
KH
Han
Young Nyun
YN
Park
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D008103:Liver Cirrhosis / Q000145:classification* / Q000473:pathology*; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D018709:Statistics, Nonparametric
chronic hepatitis B; cirrhosis; fibrosis; hepatitis B virus; hepatocellular carcinoma; laennec staging; recurrence; resection