Distinct Recurrence Risk Factors for Intrahepatic Metastasis and Multicenter Occurrence After Surgery in Patients with Hepatocellular Carcinoma
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Background and Objectives
Intrahepatic recurrence after hepatectomy for hepatocellular carcinoma (HCC) includes intrahepatic metastasis (IM) and multicenter occurrence (MO). The risk factors for these two types of intrahepatic recurrence have not been well defined.
The type of intrahepatic recurrence was determined based on histopathological features of 93 HCC patients who underwent a repeat hepatectomy for recurrent HCC. Various clinical and pathological factors were analyzed to define distinct risk factors for different types of intrahepatic recurrence.
The recurrence rates at 1, 2, 3, 5, and 8 years postoperatively were 22.4, 42.9, 61.2, 85.7, and 100 %, respectively, in patients with IM and 5.0, 25.0, 45.5, 67.5, and 100 %, respectively, in patients with MO (p = 0.005). A total of 16 clinical and pathological factors were tested in univariable and multivariable analyses. We found that large-size tumor (>5 cm), multiple tumors (two or more), and vascular invasion were significantly associated with IM recurrence, and liver cirrhosis and Ishak hepatic inflammatory activity were highly associated with MO recurrence. In addition, blood transfusion and a high hepatitis B virus (HBV)-DNA load (>2000 IU/ml) were independent risk factors common to both IM and MO recurrences.
IM and MO recurrences were associated with distinct risk factors, while blood transfusion and high HBV-DNA load (>2000 IU/ml) were independent risk factors common to both IM and MO recurrences.
KeywordsHepatocellular carcinoma Intrahepatic metastasis Multicenter occurrence Risk factor Recurrence
We thank Dr. Sheng Wei, at the School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, for his assistance in the statistical analysis of this manuscript.
Shenghua Hao designed, drafted, and revised the study critically for important intellectual content; Ping Fan acquired the data and drafted the study; Shaofei Chen analyzed the data and drafted the study; Caixue Tu interpreted the data and drafted the study; and Chidan Wan analyzed and revised the study critically for important intellectual content. All of the authors have approved the final version for publication and agreed to be accountable for all aspects of the study.
Compliance with Ethical Standards
This study was approved by the review committee of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.
Conflict of Interest
The authors declare that they have no conflicts of interest.
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