Objective: To investigate the factors for early recurrence of patients with hepatocellular carcinoma (HCC) after surgical resection.
Methods: The clinical and follow-up data of 450 HCC patients undergoing surgical resection from January 2014 to January 2016 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. The factors for early postoperative recurrence of HCC were determined by statistical analysis.
Results: Of the 450 patients, recurrence within 2 years after surgery occurred in 182 cases (40.4%). Results of univariate analysis showed that portal vein tumor thrombus and preoperative serum AFP level as well as the number, maximum diameter and differentiation of the tumor were significantly associated with the postoperative recurrence of HCC (all P<0.05). Results of Cox proportional risk regression analysis showed that lesion number (RR=2.148, 95% CI=1.175–3.924, P=0.013), maximum diameter of tumor (RR=1.591, 95% CI=1.006–2.518, P=0.047), presence and absence of the portal vein tumor thrombus (RR=1.835, 95% CI=1.242–2.709, P=0.001), serum AFP level (RR=1.722, 95% CI=1.141–2.601, P=0.010), and degree of differentiation (RR=1.463, 95% CI=1.071–1.998, P=0.017) were all independent factors for postoperative recurrence of HCC. The functional prediction equation established by incorporating these factors had certain value in estimating the early postoperative recurrence of HCC (likelihood-ratio test: χ2=45.727, P<0.001).
Conclusion: There are multiple factors that affect the early recurrence of HCC patients after surgical resection, among which portal vein tumor thrombus, lesion number, and maximum diameter and differentiation degree of the tumor and serum AFP level may be independent risk factors for recurrence. Integrated evaluation of these factors before operation has certain directive significance in preventing postoperative recurrence.