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Clinicopathological Features of Recurrence in Patients After 10-year Disease-free Survival Following Curative Hepatic Resection of Hepatocellular Carcinoma

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Abstract

Background

The present study aimed to clarify the clinicopathologic features of long-term disease-fee survival after resection of hepatocellular carcinoma (HCC).

Methods

This retrospective study identified 940 patients who underwent curative resection of HCC between 1991 and 2000 at five university hospitals. Seventy-four patients with 10 years of recurrence-free survival were identified and followed up. They were divided into two groups, 60 recurrence-free and 14 with recurrence after a 10-year recurrence-free period.

Results

Overall survival rates of recurrence and non-recurrence groups were 68 and 91 % at 16 years, and 34 and 91 % at 20 years (p = 0.02), respectively. There were five (36 %), and two deaths (3 %), respectively, after 10 recurrence-free years. A second resection for recurrence was performed in four patients (29 %), and mean survival was 15.3 years after the first hepatectomy. Although three patients in the non-recurrence group (5 %) developed esophageal and/or gastric varices, seven patients in the recurrence group (50 %) developed varices during 10 years (p < 0.0001). In multivariate analysis, preoperative and 10-year platelet count was identified as a favorable independent factor for maintained recurrence-free survival after a 10-year recurrence-free period following curative hepatic resection of HCC.

Conclusions

Recurrence of HCC may occur even after a 10-year recurrence-free period. Long-term follow-up after resection of HCC is important, and should be life-long. Patients with higher preoperative and 10-year platelet counts are more likely to have long-term survival after resection. A low platelet count, related to the degree of liver fibrosis, is a risk factor for recurrence and survival of HCC after curative resection.

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Authors and Affiliations

  1. Department of Surgery, Hirakata Hospital, Kansai Medical University, 2-3-1 Shinmachi, Hirakata, Osaka, 573-1191, Japan

    Masaki Kaibori, Morihiko Ishizaki, Kosuke Matsui & A-Hon Kwon

  2. Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, 545-8585, Japan

    Shoji Kubo, Takahiro Uenishi & Shigekazu Takemura

  3. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, 565-0871, Japan

    Hiroaki Nagano, Hiroshi Wada & Shigeru Marubashi

  4. Department of General and Gastroenterological Surgery, Osaka Medical College, Takatsuki, Osaka, 569-8686, Japan

    Michihiro Hayashi, Koji Komeda, Fumitoshi Hirokawa & Kazuhisa Uchiyama

  5. Department of Surgery, Kinki University School of Medicine, Osaka, 589-8511, Japan

    Seiji Haji, Takuya Nakai & Yasuyuki Nakata

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  1. Masaki Kaibori
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Correspondence to Masaki Kaibori.

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Kaibori, M., Kubo, S., Nagano, H. et al. Clinicopathological Features of Recurrence in Patients After 10-year Disease-free Survival Following Curative Hepatic Resection of Hepatocellular Carcinoma. World J Surg 37, 820–828 (2013). https://doi.org/10.1007/s00268-013-1902-3

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