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

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

Abstract

Background

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.

Methods

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.

Results

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).

Conclusion

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

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Disclosure

There are no competing interests.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro Gangnam-gu, Seoul, 135-710, Korea

    Won Sohn MD, PhD, Yong-Han Paik MD, PhD, Ju Yeon Cho MD, MS, Geum-Youn Gwak MD, PhD, Moon Seok Choi MD, PhD, Joon Hyeok Lee MD, PhD, Kwang Cheol Koh MD, PhD, Seung Woon Paik MD, PhD & Byung Chul Yoo MD, PhD

  2. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Jong Man Kim MD, PhD, Choon Hyuk Kwon MD, PhD & Jae Won Joh MD, PhD

Authors
  1. Won Sohn MD, PhD
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  2. Yong-Han Paik MD, PhD
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  3. Jong Man Kim MD, PhD
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  4. Choon Hyuk Kwon MD, PhD
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  6. Ju Yeon Cho MD, MS
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  8. Moon Seok Choi MD, PhD
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  9. Joon Hyeok Lee MD, PhD
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  10. Kwang Cheol Koh MD, PhD
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  11. Seung Woon Paik MD, PhD
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  12. Byung Chul Yoo MD, PhD
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Corresponding author

Correspondence to Yong-Han Paik MD, PhD.

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Sohn, W., Paik, YH., Kim, J.M. et al. HBV DNA and HBsAg Levels as Risk Predictors of Early and Late Recurrence after Curative Resection of HBV-related Hepatocellular Carcinoma. Ann Surg Oncol 21, 2429–2435 (2014). https://doi.org/10.1245/s10434-014-3621-x

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  • DOI: https://doi.org/10.1245/s10434-014-3621-x

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