Annals of Surgical Oncology

, Volume 21, Issue 7, pp 2429–2435 | Cite as

HBV DNA and HBsAg Levels as Risk Predictors of Early and Late Recurrence after Curative Resection of HBV-related Hepatocellular Carcinoma

  • Won Sohn
  • Yong-Han PaikEmail author
  • Jong Man Kim
  • Choon Hyuk Kwon
  • Jae Won Joh
  • Ju Yeon Cho
  • Geum-Youn Gwak
  • Moon Seok Choi
  • Joon Hyeok Lee
  • Kwang Cheol Koh
  • Seung Woon Paik
  • Byung Chul Yoo
Hepatobiliary Tumors



Recent studies have shown that high hepatitis B virus (HBV) load is associated with increased risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). The aim of our study was to investigate the predictive role of HBV DNA and hepatitis B surface antigen (HBsAg) levels in early and late recurrence of HCC after curative resection in patients with HBV-related HCC.


From January 2008 to December 2010, a total of 248 patients underwent curative resection for HBV-related early-stage HCC (solitary tumor; < 5 cm in diameter or multinodular tumor; number of tumors ≤3 and diameter < 3 cm). We analyzed the predictive factors including HBV DNA and HBsAg levels for early recurrence (within 2 years) and late recurrence (after 2 years) of HCC after curative resection.


The median follow-up duration was 33.3 months. Cumulative recurrence rates after resection at 1, 3, and 5 years were 16.6, 34.0, and 46.7 %, respectively. The multivariate analysis showed that risk factors for early recurrence were the presence of microvascular invasion (hazard ratio [HR] 3.86; p < 0.001), preoperative HBV DNA levels ≥ 20,000 IU/mL (HR 2.77; p < 0.001), and des-γ-carboxy prothrombin level ≥ 40 mAU/mL (HR 1.76; p = 0.045). Although, the risk factors for late recurrence by multivariate analysis were preoperative HBsAg levels ≥ 4,000 IU/mL (HR 2.80; p = 0.023) and age at resection ≥ 50 years (HR 3.22; p = 0.032).


The HBV DNA levels were associated with early recurrence, whereas HBsAg levels were associated with late recurrence after curative resection in HBV-related HCC.


Early Recurrence Late Recurrence Microvascular Invasion HBsAg Level Serum HBsAg Level 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



There are no competing interests.

Supplementary material

10434_2014_3621_MOESM1_ESM.docx (133 kb)
Supplementary material 1 (DOCX 133 kb)


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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Won Sohn
    • 1
  • Yong-Han Paik
    • 1
    Email author
  • Jong Man Kim
    • 2
  • Choon Hyuk Kwon
    • 2
  • Jae Won Joh
    • 2
  • Ju Yeon Cho
    • 1
  • Geum-Youn Gwak
    • 1
  • Moon Seok Choi
    • 1
  • Joon Hyeok Lee
    • 1
  • Kwang Cheol Koh
    • 1
  • Seung Woon Paik
    • 1
  • Byung Chul Yoo
    • 1
  1. 1.Division of Gastroenterology, Department of MedicineSamsung Medical Center, Sungkyunkwan University School of MedicineSeoulKorea
  2. 2.Department of Surgery, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea

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