title: Risk Factors for Intrahepatic Recurrence after Resection of Hepatocellular Carcinomas in Patients with Hepatitis B Virus Infection.
abstract: OBJECTIVE
  Although surgical resection offers patients with HCC the chance of a cure, the post-resection tumor recurrence rate is high, with reported cumulative 5-year tumor recurrence rates ranging from 40 to 70%. The objective of this study was to investigate risk factors for intrahepatic recurrence after resection of hepatocellular carcinoma, especially in patients with hepatitis B virus infection.
  
  
  METHODS
  Between January 1999 and December 2003, 59 patients in our Hospital with hepatitis B virus infection underwent liver resection for hepatocellular carcinoma. Clinical, biological, and histopathological characteristics of these patients were collected and tested for their prognostic significance using a Chi-square test and a Student's t-test. Time to recurrence and survival rate were analyzed by the Kaplan-Meier method.
  
  
  RESULTS
  Of the 59 patients who underwent liver resection, 24 (41%) experienced intrahepatic recurrence. The 1-, 3-, and 5-year overall survival rates of total enrolled patients were 83%, 63%, and 42%, respectively. The 1-, 3-, and 5-year overall survival rates after recurrence were 87%, 52%, and 20%, respectively. The risk factors for early recurrence were elevated serum aspartate aminotransferase (AST) level (p=0.044) and larger tumor size (p=0.049). For late recurrence, greater tumor size (p=0.039) was the only risk factor.
  
  
  CONCLUSIONS
  Tumor size and serum aspartate aminotransferase are risk factors of intrahepatic recurrence after resection of HCC in patients with chronic hepatitis B virus infection. This finding indicates that patients who have these risk factors should be under more careful supervision and have more aggressive follow-up.
authors.affiliation: Department of Surgery, Gospel Hospital, College of Medicine, Kosin University, Korea.
authors.forename: Myung Hee
authors.initials: MH
authors.lastname: Yoon
authors.affiliation: Department of Surgery, Gospel Hospital, College of Medicine, Kosin University, Korea.
authors.forename: Young Il
authors.initials: YI
authors.lastname: Choi
authors.affiliation: Department of Surgery, Gospel Hospital, College of Medicine, Kosin University, Korea.
authors.forename: Kwang Kuk
authors.initials: KK
authors.lastname: Park
authors.affiliation: Department of Surgery, Gospel Hospital, College of Medicine, Kosin University, Korea.
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Shin
authors.affiliation: Department of Surgery, Gospel Hospital, College of Medicine, Kosin University, Korea.
authors.forename: Chung Han
authors.initials: CH
authors.lastname: Lee
keywords: HBV infection; Hepatocellular carcinoma; Intrahepatic recurrence; Risk factor