Analysis Of Risk Factors Associated With Recurrence After Curative Resection For Hepatocellular Carcinoma

Objective The purpose of this study was to identify the risk factors associated with early and later recurrence after curative resection for hepatocellular carcinoma,providing scientific prevention and treatment of HCC .Methods We reviewed clinical and pathological data of 117 consecutive HCC patients given curative resection from 2003 January to 2007 December in Hepatic Surgery Center, Tongji Hospital in Wuhan.The patients were divided into two groups: early recurrence and late recurrence according to the postoperative recurrence time in two years. 11 parameters were tested by univariate analysis, those parameters of significant difference then were analysised by multivariate with the log-rank test and the Cox proportional hazards model, overall survival and disease-free survival were determined by Kaplan-Meier analysis.Results 85 patients (72.7%) experienced recurrent cancer in the follow-up,there were 59 patients in two years afteroperation, 26 patients after two years. The 1-, 3-, and 5-year overall survival rates were 64.91%, 23.03%, and 20.47% respectively in early recurrent patients. The 1-, 3-, and 5-year overall survival rates were 100%, 88.46%, and 72.5% respectively in late recurrent patients.There were statistically significant ( P < 0.001).The univariate analysis showed that AFP, AFP/V, tumor size, tumor number, invading blood vessels, degree of tumor differentiation and blood transfusion were statistically significant ( P < 0.05)in early recurrence. The multivariate analysis indicated that AFP/V, blood vessel invasion, tumor number were the independent risk factors affecting the early recurrence. Cirrhosis was the only independent risk factor in late recurrence.Conclusions The recurrence of HCC after curative resection is affected by multiple factors, AFP/V≥14ng/mlcm3, blood vessel invasion , multiple tumors were the independent risk factors in early recurrence,severe cirrhosis was the only independent risk factor in late recurrence.Overall survival rates were statistically significant in early recurrence and late recurrence.