Risk Factors for Early Recurrence of HBV-related Hepatocellular Carcinoma Meeting Milan Criteria after Curative Resection

Background: The prognosis of patients with hepatocellular carcinoma (HCC) after curative resection variesgreatly. Few studies had investigated the risk factors for early recurrence (recurrence-free time ≤ 1 year) ofhepatitis B virus (HBV)-related HCCs meeting Milan criteria.
Methods: A retrospective analysis was performedon the 224 patients with HCC meeting Milan criteria who underwent curative liver resection in our center betweenFebruary 2007 and March 2012. The overall survival (OS) rate, recurrence-free survival (RFS) rate and riskfactors for early recurrence were analyzed.
Results: After a median follow-up of 33.3 months, HCC reoccurredin 105 of 224 patients and 32 died during the period. The 1-, 3- and 5-year OS rates were 97.3%, 81.6% and75.6% respectively, and the 1-, 3- and 5-year RFS rates were 73.2%, 53.7% and 41.6%. Cox regression showedalpha-fetoprotein (AFP) > 800 ng/ml (HR 2.538, 95% CI 1.464-4.401, P=0.001), multiple tumors (HR 2.286, 95%CI 1.123-4.246, P=0.009) and microvascular invasion (HR 2.518, 95% CI 1.475-4.298, P=0.001) to be associatedwith early recurrence (recurrence-free time ≤ 1-year) of HCC meeting Milan criteria.
Conclusions: AFP > 800ng/ml, multiple tumors and microvascular invasion are independent risk factors affecting early postoperativerecurrence of HCC. In addition resection appears capable of replacing liver transplantation in some situationswith safety and a better outcome.