Prognostic Factors and 10-Year Survival in Patients with Hepatocellular Carcinoma After Curative Hepatectomy

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http://www.springerlink.com/content/w33610517243701q/

Journal of Gastrointestinal Surgery

DOI: 10.1007/s11605-011-1452-7Online Firstâ„¢

Original Article

Prognostic Factors and 10-Year Survival in Patients with Hepatocellular

Carcinoma After Curative Hepatectomy

Sung Hoon Kim, Sae Byeol Choi, Jae Gil Lee, Seung Up Kim, Mi-Suk Park, Do Young

Kim, Jin Sub Choi and Kyung Sik Kim

Abstract

Purpose

There were contrary results about the effects of hepatitis B e antigen (HBeAg)

positivity on the long-term survival in patients with hepatocellular carcinoma

(HCC) after curative resection.

Patients and Methods

Medical records of 170 HCC patients who underwent curative liver resections were

retrospectively reviewed. The 10-year survival rate and correlations among

clinical, laboratory, and pathological data, especially HBeAg, were analyzed.

Results

Fifty-two patients survived more than 10 years. The 10-year actual overall

survival (OS) rate was 30.6%, and the actual disease-free survival (DFS) rate

was 24.1%. The median OS and DFS were 76 and 35 months, respectively. In

multivariate analysis, HBeAg positivity (P = 0.032; hazard ratio

---

,

3.041), presence of a satellite nodule (P = 0.007; HR, 4.166), and elevated

ICG R15 (P = 0.003; HR, 4.915) had a significant negative correlation with

the 10-year DFS rate. In addition, HBeAg positivity (P = 0.044; HR, 3.725)

and recurrence (recur within 1 year, P < 0.001; HR, 41.296; recur after 1

year, P = 0.03; HR, 4.848) were found as independent factors which were

negatively correlated to the 10-year OS.

Conclusions

The presence of HBeAg was significantly correlated to DFS and OS after curative

resection for HCC. Active treatment of B viral hepatitis before and after

surgery should be provided to prolong survival in patients with 5–10-cm HCC.