Risk Factors For Early Recurrence And Metastasis In BCLC A Hepatocellular Carcinoma Patients After Hepatectomy

Objective To analyze the risk factors of postoperative recurrence and metastasis of related-HBV BCLC stage A(BCLC-A)hepatocellular carcinoma(HCC).Methods Data of 210 cases of liver resection for HCC were retrospectively analyzed from November 2013 and June 2016.Multivariate logistic regression analysis was used to analyze the risk factors for postoperative recurrence.The cumulative survival rates were calculated using the Kaplan-Meier method and the diffrences of the related factors between various groups were analyzed by Log-rank test.Results Univariate analysis showed that alpha-fetoprotein(AFP),neutrophil-lymphocyte ratio(NLR),hepatitis B virus surface antigen(HBsAg)positive and intraoperative transfusion were associated with early recurrence and metastasis after hepatectomy(P < 0.05).Multivariate analysis showed that AFP > 400ng/ml is an independent risk factor for early postoperative recurrence and metastasis(P=0.008).HBV DNA positive can affect the disease-free survival rate after HCC resection(P=0.030).The disease-free survival rate of patients with positive HBV-DNA at 6,12 and 24 months after hepatectomy was71.7%,60.7% and 46.5%,respectively,lower than 84.4%,71.5% and 61.1% of HCC patients with negative HBV-DNA.The differences between HBV-DNA positive and HBV-DNA negative patients in cirrhosis,AST,ALT and NLR were statistically significant(P < 0.05).Perioperative antiviral therapy can reduce the recurrence rate of related-HBV HCC patients.Conclusion AFP is an independent risk factor for early postoperative recurrence and metastasis in related-HBV HCC patients with BCLC stage A.Preoperative HBV DNA positive significantly decreases the disease-free survival rate in related-HBV HCC patients with BCLC stage A.Perioperative antiviral therapy can increases postoperative disease-free survival rate of related-HBV HCC patients with BCLC stage A.