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

World Journal of Surgery - 2013
Masaki Kaibori1, Shoji Kubo2, Hiroaki Nagano3, Michihiro Hayashi4, Seiji Haji5, Toshiko Nakai5, Morihiko Ishizaki1, Kosuke Matsui1, Takahiro Uenishi2, Shigekazu Takemura2, Hiroshi Wada3, Shigeru Marubashi3, Koji Koyama4, Fumitoshi Hirokawa4, Yoshio Nakata5, Kazuhisa Uchiyama4, A‐Hon Kwon1
1Department of Surgery, Hirakata Hospital, Kansai Medical University, Hirakata, Japan
2Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
3Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan
4Department of General and Gastroenterological Surgery, Osaka Medical College, Takatsuki, Japan
5Department of Surgery, Kinki University School of Medicine, Osaka, Japan

Tóm tắt

AbstractBackgroundThe present study aimed to clarify the clinicopathologic features of long‐term disease‐fee survival after resection of hepatocellular carcinoma (HCC).MethodsThis 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.ResultsOverall 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.ConclusionsRecurrence 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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World Journal of Surgery

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