Analysis Of Risk Factors For Early Recurrence Of Hepatocellular Carcinoma After Radical Liver Resection

Objective:To explore the risk factors for early recurrence of hepatocellular carcinoma after radical liver resection.Methods: The clinical data of 102 cases of hepatocellular carcinoma performed radical liver resection from January 2010 to September 2014 at the People’s Hospital of Guizhou Province were analyzed retrospectively. Sixteen factors involved in clinic, pathology and treatment were analyzed to determine their impact upon early recurrence of hepatocellular carcinoma,such as:age,sex, single or multiple tumor, tumor diameter, incisal margin, microvessel invasion, differentiation grade, satellite opacities,capsule invasion, anatomic hepatectomy, porta hepatis occlusion, blood transfusion, hepatitis B surface antigen(HBs Ag), cirrhosis, level of preoprative alpha-fetoprotein(AFP) and transarterial artery chemoembolization(TACE) postoprative. All patients were divided into early recurrence group(recurrence within one year after hepatectomy) and control group(no recurrence within one year after hepatectomy).The univariate analysis was carried out using chi square test, t test and Wilcoxon rank sum test. Determinants that were significant on univariate analysis were the subjected to multivariate analysis using logistic regression.Results: 102 patients were enrolled in this study.There were 79 men and 33 women.The age range from 26 to 77 years and the mean age were(53.11±11.145)years,the age of early recurrence group range from 26 to 71 years and the mean age were(49.41±10.580)years,the age of control group range from 34 to 77 years and the mean age were(57.27±10.357)years.All patients had been analysed over 1-year study period,and fifty-four cases in early recurrence group and forty-eight cases in control group.The early recurrence rate is 52.94%. There were 63 patients with the level of preoprative AFP less than or equal to 400 ug/L and 39 patients with the level of preoprative AFP more than 400 ug/L.Within two groups,there were 25 and 29 patients recurrenced within one year after hepatectomy,respectively.The tumor diameter of early recurrence group range from 2.0 to 16.0cm and the mean tumor diameter were(7.83±3.011)cm,the tumor diameter of control group range from 1.8 to 12.0cm and the mean tumor diameter were(4.75±2.113)cm.Microvessel invasion(MVI) was identified in 43 patients of which 32 recurrenced within one year after hepatectomy.High differentiation was identified in 35 patients of which 12 recurrenced within one year after hepatectomy.Moderately differentiation was identified in 57 patients of which 34 recurrenced within one year after hepatectomy.Poorly differentiation was identified in 10 patients of which 8 recurrenced within one year after hepatectomy.The univariate analysis showed that there was no significant difference between various sex,number of tumor,incisal margin,capsule invasion,porta hepatis occlusion, blood transfusion,positive of HBs Ag, cirrhosis and TACE postoprative.But various age, anatomic hepatectomy, microvessel invasion,histological grade, tumor diameter and level of preoprative AFP were significantly different for early recurrence of hepatocellular carcinoma after liver resection. Meanwhile, multivariate analysis indicated that level of preoprative AFP, tumor diameter and microvessel invasion were independent factors for early recurrence.Conclusion:Various age,anatomic hepatectomy,microvessel invasion,histological grade, level of preoprative AFP and tumor diameter were risk factors for early recurrence of hepatocellular carcinoma after radical liver resection. Microvessel invasion,level of preoprative AFP and tumor diameter were independent risk factors for early recurrence of hepatocellular carcinoma after radical liver resection.