Prognostic Factors of Postoperative Recurrence of Hepatocellular Carcinoma Evaluated with Multivariate Analysis

Hiroyuki Sugo, Yasunari Sato, Koji Matsumoto, Kuniaki Kojima, Masaki Fukasawa and Tomoe Beppu

Second Department of Surgery, Juntendo University, School of Medicine

Purpose: We evaluated prognostic factors for recurrent hepatocellular carcinoma (HCC) using multivariate analysis. Methods: Subjects were 143 patients whose cancer recurred after curative resection for HCC. For comparison, survival after recurrence was calculated based on 24 clinicopathologic variables, including 18 factors involved in the initial surgery and 6 involved in postoperative recurrence. Results: Significantly worse prognosis were noted for the following variables: male gender, no preoperative transcatheter arterial chemoembolization (TACE), liver cirrhosis, positive filtration to the capsule, positive portal involvement, short disease-free interval (<1.1 year), extrahepatic metastasis, multiple recurrence, diffuse recurrence, no reresection and clonality of the recurrent tumor (intrahepatic metastasis). Multivariate analysis showed extrahepatic metastasis (risk ratio (RR): 9.040), liver cirrhosis (RR: 6.794), and preoperative TACE (RR: 3.575) to be useful independent prognostic factors affecting survival after recurrence. Conclusions: Extrahepatic metastasis, liver cirrhosis, and preoperative TACE were important as prognostic factor in patients with recurrent HCC. Furthermore, preoperative TACE may improve postrecurrence survival.

Key words
recurrent hepatocellular carcinoma, prognosis after recurrence, preoperative transcatheter arterial chemoembolization

Reprint requests
Hiroyuki Sugo Second Department of Surgery, Juntendo University, School of Medicine 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421 JAPAN

Accepted
November 27, 2002

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