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KMID : 0870420110150020083
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
2011 Volume.15 No. 2 p.83 ~ p.89
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Risk Factors for Intrahepatic Recurrence after Resection of Hepatocellular Carcinomas in Patients with Hepatitis B Virus Infection
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Yoon Myung-Hee
Choi Young-Il
Park Kwang-Kuk
Shin Dong-Hoon
Lee Chung-Han
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Abstract
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Purpose: 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.
Conclusion: 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.
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KEYWORD
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Hepatocellular carcinoma, Intrahepatic recurrence, HBV infection, Risk factor
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