Postoperative hepatitis status as a significant risk factor for recurrence in cirrhotic patients with small hepatocellular carcinoma

✍ Scribed by Ken Shirabe; Kenji Takenaka; Akinobu Taketomi; Naoyuki Kawahara; Kazuharu Yamamoto; Mitsuo Shimada; Keizo Sugimachi

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 503 KB
• Volume: 77
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/(sici)1097-0142(19960315)77:6<1050::aid-cncr7>3.0.co;2-l

✦ Synopsis

BACKGROUND.

Recurrence of small hepatocellular carcinoma (HCC) is common. Recent studies have suggested that the status of the underlying liver parenchyma is a significant risk factor for recurrence of HCC.

METHODS.

The postoperative values of transaminase were examined every 6 months after surgery in 57 patients with a surgically resected solitary small HCC measuring up to 3 cm in greatest dimension. Based on the patterns of the transaminase values, the patients were divided into two groups. Group I (n = 20) had a high transaminase level; the values of postoperative transaminase were always more than 100 IUIL. Group I1 (n = 37) had a low transaminase level: the values of postoperative transaminase were sometimes lower than 100 IUIL. RESULTS. The cumulative carcinoma-free survival rates in Groups I and 11 were 91% and 80%, respectively, at 1 year, 64.5% and 5.5'37, respectively, at 3 years, and 48.2% and 0%, respectively, at 5 years after surgery. The disease free survival rates in Group I were significantly lower than those in Group 11 (P = 0.0007), although no significant differences in histologic risk factors for recurrence or in clinical backgrounds were observed. With regard to the recurrence pattern, solitary recurrence was more frequently observed in Group I (P = 0.021, compared with the patients in Group 11. A histologic comparison between the primary and recurrent tumor in patients who underwent re-resection for solitary recurrence demonstrated the possible multicentric occurrence of HCC in 2 of 8 patients (25%) in Group 1. CONCLUSIONS. This study suggests that the hepatitis status of the remnant liver plays an important role in the recurrence rates and patterns of small HCC after hepatectomy.