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Risk factors for recurrence after curative resection of hepatitis C ‐related hepatocellular carcinoma in patients without postoperative interferon therapy
Author(s) -
Yamashita Yoichi,
Shirabe Ken,
Toshima Takeo,
Tsuijita Eiji,
Takeishi Kazuki,
Harimoto Norifumi,
Ikegami Toru,
Yoshizumi Tomoharu,
Ikeda Tetsuo,
Soejima Yuji,
Maehara Yoshihiko
Publication year - 2013
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12091
Subject(s) - medicine , hepatocellular carcinoma , gastroenterology , hazard ratio , hepatectomy , risk factor , interferon , prothrombin time , carcinoma , surgery , resection , confidence interval , immunology
Aim Hepatitis C ( HC )‐related hepatocellular carcinoma ( HCC ; HC‐HCC ) is highly recurrent.Methods From 1995–2007, 183 curative hepatic resections for primary solitary HC‐HCC without postoperative interferon therapy were included in this study. The patients were divided into three groups: (i) 2 cm or less ( n = 56); (ii) more than 2 cm to less than 5 cm ( n = 79); and (iii) 5 cm or more ( n = 48). Independent risk factors for HC‐HCC recurrence for each group were determined. Results Independent risk factors for recurrence were aspartate aminotransferase or alanine aminotransferase ( AST / ALT ) of 80 IU/L or more (hazard ratio [ HR ], 2.1; P = 0.02) in patients with HCC of 2 cm or less, des‐γ‐carboxy prothrombin of 100 mAU/mL or more ( HR , 2.5; P = 0.02) and AST / ALT of 80 IU/L or more ( HR , 2.1; P = 0.04) in patients with HCC of more than 2 cm to less than 5 cm, and the presence of macroscopic portal vein tumor thrombus ( HR , 2.8; P = 0.02) and AST / ALT of 80 IU/L or more ( HR , 2.1; P = 0.04) in patients with HCC of 5 cm or more. All 13 late recurrences of 1 year or more after hepatic resection (27.1%) in patients with HCC of 5 cm or more were accompanied by AST / ALT of 80 IU/L or more. Conclusion AST / ALT of 80 IU/L or more is an independent risk factor for the recurrence of primary solitary HC‐HCC after curative resection irrespective of the primary HC‐HCC size.