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Risk Factors, Prognosis, and Management of Early and Late Intrahepatic Recurrence After Resection of Primary Clear Cell Carcinoma of the Liver

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Primary clear cell carcinoma of the liver (PCCCL) is an uncommon variant of hepatocellular carcinoma (HCC). The prognostic factors influencing its recurrence and survival are not clarified. This study is to evaluate the predictive factors, the therapy, and prognosis of intrahepatic recurrences after resection of PCCCL.

Methods

A total of 214 PCCCL patients treated by curative resection from January 1996 to March 2006 were retrospectively analyzed. Intrahepatic recurrences were classified into early (≤1 year) and late (>1 year) recurrences.

Results

The 1-, 3-, and 5-year overall survival (OS) rates for PCCCL patients were significantly better than those of HCC patients (P = .001). Serum a-fetoprotein (AFP) level, tumor size, liver cirrhosis, and vascular invasion were independent risk factors for both OS and disease-free survival (DFS) of PCCCL. Early and late intrahepatic recurrences developed in 28 patients and 71 patients, respectively. In multivariate analysis, ALT level and vascular invasion were independent risk factors for early recurrence, whereas age was the only significant risk factor for late recurrence. OS of late-recurrence group was significantly better than that of early-recurrence group (P = .001), and re-resection rate was higher in late than in early-recurrence group (P = .04). The 1-, 3-, and 5-year OS of patients with recurrence who received curative treatment was comparable to those who never had tumor recur (P = .71).

Conclusion

PCCCL has a better prognosis and tends to recur later than HCC. Early and late recurrences of PCCCL are linked to different predictive factors. The time to recurrence and feasibility of curative treatment are the best determinants for the prognosis.

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Acknowledgment

This work was supported by grants from the National Natural Science Foundation of China (Grant No. 30901444).

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Authors and Affiliations

  1. Department of General Surgery, Qilu Hospital, Shandong University, Jinan, China

    Tao Li MD

  2. Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China

    Jia Fan MD, Lun-Xiu Qin MD, Jian Zhou MD, Hui-Chuan Sun MD, Shuang-Jian Qiu MD, Qing-Hai Ye MD, Lu Wang MD & Zhao-You Tang MD

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  1. Tao Li MD
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Correspondence to Zhao-You Tang MD.

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T.L. and J.F. contributed equally as first author.

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Li, T., Fan, J., Qin, LX. et al. Risk Factors, Prognosis, and Management of Early and Late Intrahepatic Recurrence After Resection of Primary Clear Cell Carcinoma of the Liver. Ann Surg Oncol 18, 1955–1963 (2011). https://doi.org/10.1245/s10434-010-1540-z

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