Elevated Perioperative Transaminase Level Predicts Intrahepatic Recurrence in Hepatitis B-related Hepatocellular Carcinoma After Curative Hepatectomy

• Published in: Asian journal of surgery Vol. 31; no. 2; pp. 41 - 49
• Main Authors: Cheung, Yue-Sun, Chan, Henry L.Y., Wong, John, Lee, Kit-Fai, Poon, Terence C.W., Wong, Nathalie, Lai, Paul B.S.
• Format: Journal Article
• Language: English
• Published: China Elsevier B.V 01.04.2008; Elsevier
• Subjects: Adult; Aged; Alanine Transaminase - blood; Biomarkers, Tumor - blood; Carcinoma, Hepatocellular - diagnosis; Carcinoma, Hepatocellular - etiology; Carcinoma, Hepatocellular - surgery; Female; hepatitis activity; hepatitis B; Hepatitis B - complications; hepatocellular carcinoma; Humans; Liver Neoplasms - diagnosis; Liver Neoplasms - etiology; Liver Neoplasms - surgery; Male; Middle Aged; Neoplasm Recurrence, Local - diagnosis; recurrence; Surgery; survival; recurrence; hepatitis activity; hepatitis B; hepatocellular carcinoma; survival
• ISSN: 1015-9584
• DOI: 10.1016/S1015-9584(08)60056-1

We aimed to evaluate the role of elevated perioperative alanine aminotransferase (ALT) as a surrogate marker of hepatitis activity in determining the risk of recurrence and survival in hepatitis B-related hepatocellular carcinoma (HCC) after curative hepatectomy. A retrospective review of the hepatectomy database was performed and 142 patients were found who had hepatitis B-related HCC from January 2001 to March 2006. Their ALT levels preoperatively and 1 month, 3 months, and 6 months postoperatively were recorded. The risk factors for recurrence and prognostic factors of survival were analysed. An elevated perioperative ALT level ( p = 0.021), multiple tumour nodules in the resected specimen ( p < 0.001), and a tumour size greater than 5 cm ( p = 0.001) were significant independent risk factors for tumour recurrence. The latter two factors were also independent prognostic factors for overall survival and disease-free survival. An elevated ALT level was an independent prognostic factor for disease-free survival ( p = 0.025). An elevated perioperative ALT level, which reflects increased hepatitis activity, is an independent risk factor for intrahepatic recurrence of hepatitis B-related HCC. It is also associated with a poorer disease-free survival rate.