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Early Recurrence Risk Factors for Hepatocellular Carcinoma after Hepatic Resection: Experience at a Thai Tertiary Care Center

Narongsak Rungsakulkij MD1, Nattawut Keeratibharat MD1, Wikran Suragul MD1, Pongsatorn Tangtawee MD1, Paramin Muangkaew MD1, Somkit Mingphruedhi MD1, Suraida Aeesoa BSc1

Affiliation : 1 Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Background : Hepatic resection is a potentially curative treatment for early hepatocellular carcinoma [HCC], but early recurrence after curative resection is associated with early death and a poorer prognosis.
Objective : To identify potential risk factors for early recurrence of HCC after hepatic resection.
Materials and Methods : Patients who underwent curative hepatic resection for HCC at our institute between January 2006 and December 2015 were reviewed retrospectively and risk factors for early recurrence were analyzed.
Results : Two hundred ninety one patients were enrolled in the present study, of whom 146 (50.1%) developed tumor recurrence. Seventy-(cid:976)ive patients (51.3%) developed recurrence within one year of surgery (early recurrence group) and 71 (48.6%) developed recurrence more than one year after surgery (late recurrence group). Univariate analysis identi(cid:976)ied microvascular invasion [mVI] (hazard ratio [HR]; 2.163, 95% con(cid:976)idence interval [CI]; 1.089 to 4.298), stage II or higher (HR; 2.3691, 95% CI; 1.431 to 3.921), and tumor rupture (HR; 3.209, 95% CI; 1.369 to 7.521) as being associated with early recurrence of HCC. Among these risk factors, multivariate analysis only identi(cid:976)ied stage II or higher HCC (HR; 2.041, 95% CI; 1.131 to 3.684) as an independent risk factor for early recurrence.
Conclusion : Stage II or higher tumor is a risk factor for early recurrence following hepatic resection of HCC.

Keywords : Hepatocellular carcinoma, Liver neoplasms, Risk factors, Recurrence, Prognosis


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