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BACKGROUND:Poorer prognosis is seen in patients with hepatocellular carcinoma (HCC) after curative hepatic resection with early recurrence (≤1 year) than in those with late recurrence (>1 year).This study aimed to identify risk factors for postoperative early recurrence of small HCC (≤3 cm in diameter).METHODS:The study population consisted of 158 patients who underwent curative resection for small HCC between January 2002 and July 2004.Risk factors for early recurrence were analyzed.RESULTS:Thirty-three (20.8%) patients developed early recurrence after surgery.Univariate analysis showed the following significant risk factors for early recurrence in small HCC:serum alpha-fetoprotein (AFP) level >100 ng/ml,lack of tumor capsule formation,microscopic vascular invasion,high Edmonson-Steiner grades,and cytokeratin-19 (CK-19) expression (P<0.05).Multivariate stepwise logistic regression analysis showed that serum AFP level >100 ng/ml (odds ratio 2.561,95% confidence interval 1.057 to 6.206,P=0.037) and microscopic vascular invasion (odds ratio 4.549,95% confidence interval 1.865 to 11.097,P=0.001) were independent factors.CONCLUSIONS:Postoperative early recurrence is related to serum AFP level >100 ng/ml and microscopic vascular invasion in patients with small HCC.Adjuvant therapy and careful follow-up are required for patients with these risk factors.
BACKGROUND: Poorer prognosis is seen in patients with hepatocellular carcinoma (HCC) after curative hepatic resection with early recurrence (<1 year) than in with with recur recurrence (> 1 year). This study aimed to identify risk factors for postoperative early recurrence of Small HCC (≤3 cm in diameter) .METHODS: The study population consisted of 158 patients who underwent curative resection for small HCC between January 2002 and July 2004.Risk factors for early recurrence were analyzed.RESULTS: Thirty-three (20.8%) patients developed early recurrence after surgery. Univariate analysis showed the following significant risk factors for early recurrence in small HCC: serum alpha-fetoprotein (AFP) level> 100 ng / ml, lack of tumor capsule formation, microscopic vascular invasion, high Edmonson-Steiner grade, and cytokeratin-19 (CK-19) expression (P <0.05) .Multivariate stepwise logistic regression analysis showed that serum AFP level> 100 ng / ml (odds ratio 2.561, 95% confidence interval 1.057 to 6. 206, P = 0.037) and microscopic vascular invasion (odds ratio 4.549, 95% confidence interval 1.865 to 11.097, P = 0.001) were independent factors. CONCLUSIONS: Postoperative early recurrence is related to serum AFP level> 100 ng / ml and microscopic vascular invasion in patients with small HCC. Adjuvant therapy and careful follow-up are required for patients with these risk factors.