title: Early recurrence in large hepatocellular carcinoma after curative hepatic resection: prognostic significance and risk factors.
abstract: OBJECTIVE
  So far, prognostic significance and risk factors of early recurrence after curative resection in large hepatocellular carcinoma (LHCC) remain unclear. The present study aimed to answer these questions.
  
  
  METHODS
  Clinical, pathologic and follow-up data of consecutive 116 patients with LHCC (>5cm) after curative resection were collected and analyzed. The recurrence pattern of LHCC was also compared with that of 55 patients with small HCC (SHCC, ≤5cm).
  
  
  RESULTS
  Forty-five patients (38.8%) with LHCC developed recurrence within 1 year after surgery (defined as early recurrence), with a significantly higher ratio contrast to those with SHCC. Univariate analysis showed that age, HBsAg positivity, satellite nodule, TNM stage, resection extent and early recurrence served as significant indicators of post-recurrence overall survival in recurrent LHCC. In addition, only early recurrence was proven to be significant in multivariate Cox regression test. On the other hand, age, HBsAg positivity, portal vein tumor thrombosis, microvascular invasion, TNM stage, Edmondson-Steiner grade and resection extentwere related to early recurrence in LHCC. Among them, microvascular invasion and Edmondson-Steiner grade were independent predictors.
  
  
  CONCLUSIONS
  Patients with early recurrence carried very poor post-recurrence prognosis in LHCC. The microvascular involvement and differentiation grade might be particularly helpful for prediction of early recurrence.
authors.forename: Li
authors.initials: L
authors.lastname: Zhou
authors.forename: Jing-An
authors.initials: JA
authors.lastname: Rui
authors.forename: Shao-Bin
authors.initials: SB
authors.lastname: Wang
authors.forename: Shu-Guang
authors.initials: SG
authors.lastname: Chen
authors.forename: Qiang
authors.initials: Q
authors.lastname: Qu
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D002454:Cell Differentiation; D016009:Chi-Square Distribution; D002681:China; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D055806:Microvessels / Q000473:pathology; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden