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World Journal of Surgery
Published in: World Journal of Surgery 4/2013

01-04-2013

Clinicopathological Features of Recurrence in Patients After 10-year Disease-free Survival Following Curative Hepatic Resection of Hepatocellular Carcinoma

Authors: Masaki Kaibori, Shoji Kubo, Hiroaki Nagano, Michihiro Hayashi, Seiji Haji, Takuya Nakai, Morihiko Ishizaki, Kosuke Matsui, Takahiro Uenishi, Shigekazu Takemura, Hiroshi Wada, Shigeru Marubashi, Koji Komeda, Fumitoshi Hirokawa, Yasuyuki Nakata, Kazuhisa Uchiyama, A-Hon Kwon

Published in: World Journal of Surgery | Issue 4/2013

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Abstract

Background

The present study aimed to clarify the clinicopathologic features of long-term disease-fee survival after resection of hepatocellular carcinoma (HCC).

Methods

This retrospective study identified 940 patients who underwent curative resection of HCC between 1991 and 2000 at five university hospitals. Seventy-four patients with 10 years of recurrence-free survival were identified and followed up. They were divided into two groups, 60 recurrence-free and 14 with recurrence after a 10-year recurrence-free period.

Results

Overall survival rates of recurrence and non-recurrence groups were 68 and 91 % at 16 years, and 34 and 91 % at 20 years (p = 0.02), respectively. There were five (36 %), and two deaths (3 %), respectively, after 10 recurrence-free years. A second resection for recurrence was performed in four patients (29 %), and mean survival was 15.3 years after the first hepatectomy. Although three patients in the non-recurrence group (5 %) developed esophageal and/or gastric varices, seven patients in the recurrence group (50 %) developed varices during 10 years (p < 0.0001). In multivariate analysis, preoperative and 10-year platelet count was identified as a favorable independent factor for maintained recurrence-free survival after a 10-year recurrence-free period following curative hepatic resection of HCC.

Conclusions

Recurrence of HCC may occur even after a 10-year recurrence-free period. Long-term follow-up after resection of HCC is important, and should be life-long. Patients with higher preoperative and 10-year platelet counts are more likely to have long-term survival after resection. A low platelet count, related to the degree of liver fibrosis, is a risk factor for recurrence and survival of HCC after curative resection.
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Metadata
Title
Clinicopathological Features of Recurrence in Patients After 10-year Disease-free Survival Following Curative Hepatic Resection of Hepatocellular Carcinoma
Authors
Masaki Kaibori
Shoji Kubo
Hiroaki Nagano
Michihiro Hayashi
Seiji Haji
Takuya Nakai
Morihiko Ishizaki
Kosuke Matsui
Takahiro Uenishi
Shigekazu Takemura
Hiroshi Wada
Shigeru Marubashi
Koji Komeda
Fumitoshi Hirokawa
Yasuyuki Nakata
Kazuhisa Uchiyama
A-Hon Kwon
Publication date
01-04-2013
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 4/2013
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-013-1902-3

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