The Risk Factors For Early Recurrence After Resection Of Large Hepatocellular Carcinoma

Objective:To explore risk factors influence recurrence after resection of largehepatocellular carcinoma(LHCC),And provide a scientific basis of comprehensivetreatment after resection of large hepatocellular carcinomaMethods：From January2008to December2010,95patients who the pathologicaldiagnosis of hepatocellular carcinoma in The First Affiliated Hospital of FujianMedical University were enrolled for reviewing clinical factors.By measuring,thediameter of tumor is5cm to10cm.Univarite analysis and multivariate analysis the riskfactors influence recurrence after resection of LHCC,such as the aspect of patients(sex,age,AFP,HBsAg,HBV-DNA,TBIL,GGT,ALT、ascities,hepatocirrhosis),theaspect of tumor (envelope,number,diameter,microscopic vascular invasion,macroscopic vascular invasion,differentiation) and the aspect of surgery(transfusion、surgical margin、obstructive time of portal vein、antiviral therapy)，COX’s regressionmodel of multivariate analyzes was done in order to determin clinical factors whichhad influenced recurrence after resection of LHCC.Results：Up to endpoint,73patients(76.8%) was recurrenced in95cases ofLHCC,the mean interval of recurrence was6.2months(1to22months).Univariteanalysis showed that the risk factors for early recurrence after resection of LHCCassociated with hepatocirrhosis（P=0.000）,tumor envelope （P=0.024）, macroscopicvascular invasion （P=0.004）,tumor differentiation（P=0.002）,obstructive time ofportal vein（P=0.017）.The COX multivariate model indicated that independent riskfactors were hepatocirrhosis（P=0.025）,macroscopic vascular invasion(P=0.046),tumor differentiation (P=0.008).Conclusions:2years after surgery for the peak period of recurrence of largehepatocellular carcinoma. hepatocirrhosis, tumor envelope, macroscopic vascular invasion,tumor differentiation and and obstructive time of portal vein are associatedwith early recurrence after resection of large hepatocellular carcinoma.Andmacroscopic vascular invasion, mixed-large nodular cirrhosis of the liver, low degree oftumor differentiation are the main and decisive factors.