Journal of Gastrointestinal Surgery

, Volume 14, Issue 7, pp 1111–1120 | Cite as

High Hepatitis B Viral Load Predicts Recurrence of Small Hepatocellular Carcinoma after Curative Resection

  • Li-Shuai Qu
  • Fei Jin
  • Xiao-Wu Huang
  • Xi-Zhong Shen
Original Article


A retrospective cohort study was conducted to identify risk factors for recurrence of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative resection. A total of 317 patients who had received curative resection of pathologically proven small HCC (≤3 cm in diameter) were analyzed to ascertain the factors affecting recurrence. The median follow-up period was 33.7 months. Cumulative recurrence rates at 1, 3, and 5 years after resection were 23.5%, 49.5%, and 65.5%, respectively. Male sex, alpha-fetoprotein (AFP) ≥400 ng/mL, HBV DNA level ≥4 log10 copies/mL, prolonged prothrombin time, tumor size ≥2 cm, microvascular invasion, absence of capsular formation, moderate/poor tumor differentiation, and absence of postoperative interferon-alpha (IFN-α) treatment were associated with increased cumulative risk of HCC recurrence. By multivariate analysis, HBV DNA level ≥4 log10 copies/mL (P < 0.001, hazard ratio (HR) 2.110), AFP ≥400 ng/mL (P = 0.011, HR 1.574), microvascular invasion (P < 0.001, HR 1.767), and postoperative IFN-α treatment (P = 0.022, HR 0.562) remained to be independently associated with HCC recurrence. Those contributing to late recurrence (>2 years) were older age and HBV DNA level ≥4 log10 copies/mL. Patients with persistent HBV DNA level ≥4 log10 copies/mL at resection and follow-up had the highest recurrence risk (P < 0.001, HR 4.129). HBV DNA level ≥4 log10 copies/mL at the time of resection was the most important risk factor for recurrence. Postoperative IFN-α treatment significantly decreased the recurrence risk after resection.


Hepatocellular carcinoma Recurrence Hepatitis B viral load 



We thank Professor Nai-qing Zhao, Shanghai Medical College, Fudan University, China, for guide in the statistical analysis.

Potential competing interests



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Copyright information

© The Society for Surgery of the Alimentary Tract 2010

Authors and Affiliations

  • Li-Shuai Qu
    • 1
  • Fei Jin
    • 1
  • Xiao-Wu Huang
    • 2
  • Xi-Zhong Shen
    • 1
  1. 1.Department of Gastroenterology and Hepatology, Zhongshan HospitalFudan UniversityShanghaiChina
  2. 2.Liver Cancer Institute, Zhongshan HospitalFudan UniversityShanghaiChina

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