Analysis Of Prognostic Factors Of Repeated Hepatectomy For Recurrent Of Barcelona Clinic Liver Cancer Stage A Hepatocellular Carcinoma

Objective:The aim of this retrospective study was to investigate the prognostic factors of repeated hepatectomy for recurrent of Barcelona Clinic Liver Cancer Stage A hepatocellular carcinoma.Methods: The clinical and follow-up data of 48 cases who underwent repeated hepatectomy for recurrent HCC in Affiliated Hospital of Q ingdao University from Jan 2002 to July 2015 were retrospectively reviewed and analyzed.41 patients were males,7 patients were females,the mean age of patients in this study was 56 years(30-77 years),the time of follow-up until September 30,2017.The Kaplan-Meier(Log-rank test)method was used to analyze the risk factors of long-term survival and diseases-free survival in patients with HCC after repeated hepatectomy,and then into the Cox re gression equation to explore the independent risk factors affecting the prognosis factors of repeated hepatectomy for recurrent of Barcelona Clinic Liver Cancer Stage A hepatocellular carcinoma.Results:The median follow-up time of all 48 patients in this group was 57.9(2.0-119.3)months.The 1,2,5 years of OS and DFS were 88.3%,71.6%,49.5% and 61.7%,42.6%,26.3% in the group BC LC A patients after repeated hepatectomy.Kaplan-Meier single factor analysis showed that the portal hypertension,the HBV patients who did not receive postoperative antiviral therapy,late TNM staging,a perioperative period of blood transfusion,and a recurrence interval of less than 2 years from the first operation time.These factors could significantly reduce the postoperative OS rate(P<0.05),which was a risk factor for the long-term survival of the patients after the resected hepatectomy,and the patient had a history of diabetes in the recurrence of liver resection.The preoperative combination of liver cirrhosis and the time interval between the first operation and the first operation were less than 2 years.These factors could significantly reduce the postoperative DFS rate,which was a risk factor for the survival of the patients after the recurrence of the resected liver.The Cox regression model showed that the HBV patients who did not receive postoperative antiviral therapy(P=0.003),TNM staging was late(P=0.001)and short recurrence interval(P=0.004)was an independent risk factor for the long-term survival of patients with BC LC A stage liver cancer;the recurrence of liver cirrhosis(P=0.030)and short recurrence interval(P=0.000)from the first operation(P=0.000)affected BCLC A.Independent risk factors for recurrence free survival in patients with recurrent liver cancer.Conclusion: The early recurrence of less than 2 years is an independent risk factor for the prognosis of hepatectomy in patients with BCLC A,moreover,the active antiviral therapy and regular follow-up treatment,and early detection of recurrence and early treatment can lead to better prognosis.