Risk Factors for Early and Late Intrahepatic Recurrence in Patients with Single Hepatocellular Carcinoma Without Macrovascular Invasion after Curative Resection


Background: Prognostic factors of postoperative early and late recurrence in patients with hepatocellularcarcinoma (HCC) undergoing curative resection remain to be clarified. The aim of this study was to identifyrisk factors for postoperative early (≤ 2 year) and late (> 2 year) intrahepatic recurrences in patients with singleHCCs without macrovascular invasion.
Methods: A total of 280 patients from December 2004 to December2007 were retrospectively included in this study. Intrahepatic recurrence was classified into early (≤ 2 year) andlate (> 2 year) and the Chi-Square test or Fisher’s exact test and multivariate logistic regression analysis wereperformed to determine significant risk factors.
Results: During the follow-up, 124 patients had intrahepaticrecurrence, early and late in 82 and 42 patients, respectively. Multivariate logistic regression analysis showedthat microvascular invasion (p=0.006, HR: 2.397, 95% CI: 1.290–4.451) was the only independent risk factorfor early recurrence, while being female (p = 0.031, HR: 0.326, 95% CI: 0.118–0.901), and having a high degreeof cirrhosis (P=0.001, HR: 2.483, 95% CI: 1.417–4.349) were independent risk factors for late recurrence.
Conclusions: Early and late recurrence of HCC is linked to different risk factors in patients with single HCCwithout macrovascular invasion. This results suggested different emphases of strategies for prevent of recurrenceafter curative resection, more active intervention including adjuvant therapy, anti-cirrhosis drugs and carefulfollow-up being necessary for patients with relevant risk factors.