This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Liver fibrosis increases the risk of intrahepatic recurrence after hepatectomy for hepatocellular carcinoma. BJS 2002; 89: 57-62.
Published: 5th November 2002
Authors: S. Ko, H. Kanehiro, M. Hisanaga, M. Nagao, N. Ikeda, Y. Nakajima et al.
Background
Hepatocellular carcinoma (HCC) commonly develops in patients with chronic hepatitis. Intrahepatic recurrence after hepatectomy often includes nodules of new tumour in the liver remnant. The aim of this study was to examine hepatitis‐related factors that might predict this type of recurrence.
Method
The influence of various hepatitis‐related factors on intrahepatic recurrence of HCC was studied by multivariate analysis in 138 patients who underwent curative resection and were followed for more than 2 years.
Results
The Cox proportional hazard model showed that histological evidence of fibrosis of the underlying liver was the most significant predictive factor for intrahepatic recurrence (P = 0·001). Serum albumin level was also significantly associated with recurrence (P = 0·038). The relative risks of histological fibrosis and low serum albumin levels were 8·9 and 1·7 respectively. Among tumour‐related factors, only tumour size was significantly associated with recurrence (P = 0·017). Major hepatectomy was also an independent risk factor for intrahepatic recurrence (P = 0·004).
Conclusion
Histological evidence of fibrosis and low serum albumin levels are useful predictors of intrahepatic recurrence after hepatectomy, presumably owing to metachronous multifocal tumour in the liver remnant. © 2002 British Journal of Surgery Society Ltd
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