Background/Aims
Early recurrence (ER) after liver resection is one of the most important factors
impacting the prognosis and survival of patients with hepatocellular carcinoma (HCC). This study aimed to
identify the factors associated with ER after curative hepatic resection for HCC. Methods: From the July 2000
to July 2006, 144 patients underwent hepatic resection for HCC at a single institution. After excluding those
with ruptured HCC, combined or mixed HCC, and who died during admission, 116 patients were analyzed.
Patients with ER (defined as within 1 year) were compared with those who remained free of disease for more
than 1 year. Various clinical characteristics including tumor and operative factors were evaluated to determine
the factors predicting postoperative ER using univariate and multivariate analyses. Results: ER occurred in
51 patients (44%). In the univariate analysis, tumor size (P=0.001), microvascular invasion (P=0.003), portal
vein invasion (P=0.001), TNM stage (P=0.010), serum levels of alpha-fetoprotein (AFP) (P=0.002) and aspartate
aminotransferase (AST) (P=0.011), and operative time (P=0.033) were significantly associated with ER.
AFP and AST were the independent predictors of ER in the multivariate analysis (P<0.05). Conclusions:
Preoperative serum AFP and AST levels were the independent risk factors for ER after surgical resection for
HCC. Close postoperative surveillance is recommended for early detection of recurrence and additional treatments
in patients with these factors. (Korean J Hepatol 2008;14:371-380)
