Risk Factors for Hepatocellular Carcinoma Recurrence: Experience at a Thai Tertiary Care Center

Authors

  • Narongsak Rungsakulkij Division of Hepato-Pancreato-Biliary Surgery, Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Wikran Suragul Division of Hepato-Pancreato-Biliary Surgery, Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Pongsatorn Tangtawee Division of Hepato-Pancreato-Biliary Surgery, Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Paramin Muangkaew Division of Hepato-Pancreato-Biliary Surgery, Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Somkit Mingphruedhi Division of Hepato-Pancreato-Biliary Surgery, Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Panuwat Lertsitthichai Division of Breast and Endocrine Surgery, Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Keywords:

Hepatocellular carcinoma, local recurrence, risk factors, microvascular invasion, hepatectomy

Abstract

Background: Hepatocellular carcinoma (HCC) is the most common primary liver cancer worldwide. Liver
resection is the treatment of choice for early HCC. The recurrence rate after curative resection is a major problem.
Purposes: To identify risk factors for HCC recurrence after curative resection.   Methods: A retrospective review of medical records of patients with HCC who underwent curative resection
during the period January 2006 to September 2011.
Results: One hundred and thirty five patients were included in the study. There were 100 men (74%) and 35
women (26 %). The overall recurrence rate was 50 % (67/135) with a mean follow-up time of 40.7 months. The most
significant risk factor for tumor recurrence was the presence of vascular invasion.
Conclusion: The recurrence rate was 50 %. Vascular invasion was found to be a significant risk factor for HCC
recurrence.

References

1. Vatanasapt V, Sriamporn S, Vatanasapt P. Cancer control
in Thailand. Jpn J ClinOncol 2002;32:S82-91.

2. Jemal A, Siegal R, Xu J, et al. Cancer statistics. 2010. CA Can
J Clin 2010;60:277-300.

3. Imamura H, Seyama Y, Kokudo N, et al. One thousand fiftysix
hepatectomies without mortality in 8 years. Arc Surg
2003;138:1198-206.

4. Fan ST, Lo CM, Liu CL, et al. Hepatectomy for hepatocellular
carcinoma toward zero hospital deaths. Ann Sur 1999;
229:322-30.

5. Imamura H, Matsuyama Y, Tanaka E, et al. Risk factors
contributing to early and late phase intrahepatic recurrence
of recurrence of hepatocellular carcinoma after
hepatectomy. J Hepatol 2003;38:200-7.

6. Cha C, Fong Y, Jarnagin WR, et al. Predictors and patterns
of recurrence after resection of hepatocellular carcinoma.
J Am Coll Surg 2003;197:753-8.

7. Poon RT, Fan ST, Wong J. Risk factors, prevention, and
management of postoperative recurrence after resection
of hepatocellular carcinoma. Ann Surg 2000;232:10-24.

8. Ho CM, Wu CY, Lee CH, et al. Analysis of the risk factors of
untransplantable recurrence after primary curative resection
for patients with hepatocellular carcinoma. Ann Surg Oncol
2013;20:2526-33.

9. Qin LX, Tang ZU. The prognostic significance of clinical and
pathological features in hepatocellular carcinoma. World J
Gastroenterol 2002;8:193-9.

10. Rodriguez-Peralvarez M, Luong TV, Andreana L, et al. A
systematic review of microvascular invasion in hepatocellular
carcinoma: diagnostic and prognostic variability. Ann
SurgOncol 2013;20:325-39.

11. Portolani N, Coniglio A, Ghidoni S, et al. Early and late
recurrence after liver resection for hepatocellular carcinoma
prognostic and therapeutic implications. Ann Surg
2006;243:229-35.

12. Wang CC, Iyer SG, Low JK, et al. Perioperative factors
affecting long-term outcomes of 473 consecutive patients
undergoing hepatectomy for hepatocellular carcinoma.
Ann SurgOncol 2009;16:1832-42.

13. Meniconi RL, Komatsu S, Perdigao F, et al. Recurrent
hepatocellular carcinoma: A Western strategy that
emphasizes the impact of pathologic profile of the first
resection. Surgery 2015;157:454-62.

14. Sumie S, Nakashima O, Okuda K, et al. The Significance of
classifying microvascular invasion in patients with
hepatocellular carcinoma. Ann Surg Oncol 2014; 21:1002-9.

15. Nagasue N, Ono T, Yamanoi A, et al. Prognostic factors and
survival after hepatic resection for hepatocellular carcinoma
without cirrhosis. Br J Surg 2001;88:515-22.

16. Fan ST, Poon RT, Yeung C, et al. Outcome after partial
hepatectomy for hepatocellular cancer within the Milan
criteria. Br J Surg 2011;98;1292-300.

17. Lim KC, Chow PK, Allen JC, et al. Microvascular invasion is a
better predictor of tumor recurrence and overall survival
following surgical resection for hepatocellular carcinoma
compared to the Milan criteria. Ann Surg 2011;254:108-13.

18. Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation
for the treatment of small hepatocellular carcinomas in
patients with cirrhosis. N Engl J Med 1996;334:693-9.

19. Poon RT, Fan ST, Lo CM, et al. Difference in tumor invasiveness
in cirrhotic patients with hepatocellular carcinoma fulfilling
the Milan criteria treated by resection and transplantation
impact on long-term survival. Ann Surg 2001;245:51-8.

Downloads

Published

2016-07-01

How to Cite

1.
Rungsakulkij N, Suragul W, Tangtawee P, Muangkaew P, Mingphruedhi S, Lertsitthichai P. Risk Factors for Hepatocellular Carcinoma Recurrence: Experience at a Thai Tertiary Care Center. Thai J Surg [Internet]. 2016 Jul. 1 [cited 2024 May 7];37(3). Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/225838

Issue

Section

Original Articles