The preoperative positivity for serum hepatitis B e antigen did not affect overall survival after curative resection of hepatitis B virus-related hepatocellular carcinoma.

Full Abstract

BACKGROUND AND AIM: Previous studies have reported different risk factors for early and late intrahepatic recurrence after resection of hepatocellular carcinoma (HCC). However, the prognostic significance of the risk factors for early and late recurrence has not been clarified. METHODS: A total of 190 Hepatitis B surface antigen-positive patients who received curative resection for HCC were reviewed. We investigated prognostic factors for disease-free and overall survival after resection, and further analyzed the relationship between significant prognostic factors and risk factors for early (14 months) intrahepatic recurrence. RESULTS: The 5-year disease-free and overall survival rates were 43.9% and 71.5%, respectively. In multivariate analysis, adverse prognostic factors for disease-free survival were presence of serum HBeAg, perioperative transfusion, and the presence of portal vein invasion (PVI) and/or intrahepatic metastasis (IM). Multivariate analysis revealed that overall survival was associated with ICG R15, serum albumin, Edmondson-Steiner grade, and the presence of PVI and/or IM. Independent risk factors for early intrahepatic recurrence were perioperative transfusion and PVI and/or IM, whereas positivity for HBeAg was the only risk factor for late recurrence. In addition, post-recurrence survival in patients with late intrahepatic recurrence was completely comparable to that of patients who never experienced recurrence. CONCLUSIONS: The presence of serum HBeAg, the risk factor for late intrahepatic recurrence did not affect overall survival after resection because late recurrence was relatively well controlled by current available treatments. To further improve long-term surgical outcomes, effective treatment and preventive methods for early intrahepatic recurrence should be investigated.

Author information

Author/s: Choi, Gi Hong (GH); Kim, Dong Hyun (DH); Choi, Sae Byeol (SB); Kang, Chang Moo (CM); Kim, Kyung Sik (KS); Choi, Jin Sub (JS); Lee, Woo Jung (WJ); Han, Kwang Hyub (KH); Chon, Chae Yoon (CY); Kim, Byong Ro (BR);

Affiliation: Department of Surgery, Yonsei University Health System, Seoul, Korea.

Journal and publication information

Publication Type: Journal Article

Journal: Journal of gastroenterology and hepatology (J Gastroenterol Hepatol), published in Australia. (Language: eng)

Reference: 2009-Mar; vol 24 (issue 3) : pp 391-8

Dates: Created 2009/04/01; Completed 2009/06/25;

PMID: 19032452, status: MEDLINE (last retrieval date: 6/25/2009, IMS Date: )

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Aged
Biological Markers - blood
Blood Loss, Surgical - prevention & control
Blood Transfusion
Carcinoma, Hepatocellular - mortality; surgery; virology
Disease-Free Survival
Female
Hepatectomy
Hepatitis B - complications; immunology; mortality; surgery
Hepatitis B e Antigens - blood
Humans
Kaplan-Meiers Estimate

Associated Chemicals: Biological Markers (0) ; Hepatitis B e Antigens (0)

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