Characteristics of Early Recurrence After Curative Liver Resection for Solitary Hepatocellular Carcinoma
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Early recurrence after liver resection of hepatocellular carcinoma (HCC) has a great effect on the survival of patients. The aims of this study were to identify risk factors for early recurrence and to clarify whether early recurrence is related to patient survival rate.
We identified a total of 1010 patients with HCC recurrence after hepatic resection between 2009 and 2014 in Samsung Medical Center and Seoul National University Hospital. Inclusion criteria were preoperative solitary tumor Child-Pugh class A and curative hepatectomy. Early recurrence was defined as HCC recurrence < 1 year after surgery.
A total of 628 patients were included in this study: 302 with early recurrence and 326 with late recurrence. Multivariate analysis showed that HCC grade 3 or 4, tumor size > 3 cm, and microvascular invasion were closely associated with early recurrence after liver resection for solitary HCC. When HCC recurred, the early recurrence group had large tumor size, increased tumor numbers and AFP levels, and high incidence of diffuse intrahepatic recurrence compared with the late recurrence group. The overall survival curve for the early recurrence group was lower than that for the late recurrence group (P < 0.001). Multivariate analysis demonstrated early recurrence was closely associated with patient survival.
Patients with early recurrence had different characteristics compared to patients with late recurrence after hepatic resection in solitary HCC. Early detection of recurrence is necessary through active postoperative surveillance in hepatectomy patients with poor prognostic factors.
KeywordsEarly recurrence Hepatocellular carcinoma Hepatectomy Tumor recurrence
Sung Mi Jung: literature search, data analysis and interpretation and writing
Jong Man Kim: design, literature search, data acquisition, analysis, and interpretation and writing
Jae-Won Joh: design and data interpretation
Nam Joon Yi, Gyu-Seong Choi, Choon Hyuck David Kwon, Kwang-Woong Lee, and Kyung-Suk Suh: acquisition and analysis of data
This work was funded by the Korean Liver Cancer Association.
Compliance with Ethical Standards
This study was approved by the Samsung Medical Center Institutional Review Board (SMC 2013-05-013) and Seoul National University Hospital Institutional Review Board (H-1303-061-474).
- 13.Hayashi M, Shimizu T, Hirokawa F, Inoue Y, Komeda K, Asakuma M, Miyamoto Y, Takeshita A, Shibayama Y, Tanigawa N. Clinicopathological risk factors for recurrence within one year after initial hepatectomy for hepatocellular carcinoma. Am Surg 2011;77:572–578.Google Scholar
- 19.Lim KC, Chow PK, Allen JC, Chia GS, Lim M, Cheow PC, Chung AY, Ooi LL, Tan SB. Microvascular invasion is a better predictor of tumor recurrence and overall survival following surgical resection for hepatocellular carcinoma compared to the Milan criteria. Ann Surg 2011;254:108–113.CrossRefGoogle Scholar