Distinct Recurrence Risk Factors for Intrahepatic Metastasis and Multicenter Occurrence After Surgery in Patients with Hepatocellular Carcinoma.
Intrahepatic recurrence after hepatectomy for hepatocellular carcinoma (HCC) includes intrahepatic metastasis (IM) and multicenter occurrence (MO). The risk factors for these two types of intrahepatic recurrence have not been well defined.



The type of intrahepatic recurrence was determined based on histopathological features of 93 HCC patients who underwent a repeat hepatectomy for recurrent HCC. Various clinical and pathological factors were analyzed to define distinct risk factors for different types of intrahepatic recurrence.



The recurrence rates at 1, 2, 3, 5, and 8 years postoperatively were 22.4, 42.9, 61.2, 85.7, and 100 %, respectively, in patients with IM and 5.0, 25.0, 45.5, 67.5, and 100 %, respectively, in patients with MO (p = 0.005). A total of 16 clinical and pathological factors were tested in univariable and multivariable analyses. We found that large-size tumor (>5 cm), multiple tumors (two or more), and vascular invasion were significantly associated with IM recurrence, and liver cirrhosis and Ishak hepatic inflammatory activity were highly associated with MO recurrence. In addition, blood transfusion and a high hepatitis B virus (HBV)-DNA load (>2000 IU/ml) were independent risk factors common to both IM and MO recurrences.



IM and MO recurrences were associated with distinct risk factors, while blood transfusion and high HBV-DNA load (>2000 IU/ml) were independent risk factors common to both IM and MO recurrences.
Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei, 430022, China. haoshenghua@126.com.
Shenghua
0000-0001-8836-640X
S
Hao
Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei, 430022, China.
Ping
P
Fan
Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei, 430022, China.
Shaofei
S
Chen
Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei, 430022, China.
Caixue
C
Tu
Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei, 430022, China.
Chidan
C
Wan
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology / Q000401:mortality / Q000473:pathology*; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
Hepatocellular carcinoma; Intrahepatic metastasis; Multicenter occurrence; Recurrence; Risk factor