Hepatitis viral status affects the pattern of intrahepatic recurrence after resection for hepatocellular carcinoma

• Published in: European journal of surgical oncology Vol. 29; no. 3; pp. 266 - 271
• Main Authors: Wakai, T, Shirai, Y, Yokoyama, N, Nagakura, S, Hatakeyama, K
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.04.2003
• Subjects: Adolescent; Adult; Aged; Analysis of Variance; Carcinoma, Hepatocellular - surgery; Carcinoma, Hepatocellular - virology; Chi-Square Distribution; Female; Hepatitis B - complications; Hepatitis C - complications; Hepatitis E - complications; hepatocellular carcinoma, hepatitis viral status, hepatic resection, intrahepatic recurrence, prognosis; Humans; Liver Neoplasms - surgery; Liver Neoplasms - virology; Male; Middle Aged; Neoplasm Recurrence, Local; Prognosis; Proportional Hazards Models; Risk Factors; Survival Analysis; hepatocellular carcinoma, hepatitis viral status, hepatic resection, intrahepatic recurrence, prognosis
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1053/ejso.2002.1395

Aim: To define whether the patterns of intrahepatic recurrence after resection for hepatocellular carcinoma differ according to hepatitis viral status. Methods: One hundred and eleven patients undergoing a curative resection for hepatocellular carcinoma were divided into three groups: the C-viral group (n=55), which tested positive for hepatitis C antibody; the B-viral group (n=32), which tested positive for hepatitis B surface antigen; and the non-B non-C (NBNC) group (n=24), which tested negative for both hepatitis B surface antigen and hepatitis C antibody. The long-term outcomes were analyzed retrospectively. Results:The pattern of development of intrahepatic recurrence differed between the NBNC group and the other groups: the cumulative probability of intrahepatic recurrence reached a plateau at 2.4 years after resection in the NBNC group, while it continued to increase steadily in the hepatitis viral groups. The C-viral group showed a higher incidence of intrahepatic recurrence than the other groups by univariate (P=0.0306) and multivariate (relative risk=1.69, P=0.0429) analyses. Multiple intrahepatic recurrent lesions were more common in the C-viral group (P=0.0457). Conclusions: Multicentric carcinogenesis in the remnant liver was less common in the NBNC group than in hepatitis viral groups. Hepatitis C virus infection is a significant risk factor for intrahepatic recurrence after resection and is also associated with multiple intrahepatic recurrent lesions.