Risk factors for recurring hepatocellular carcinoma differ according to infected hepatitis virus-An analysis of 236 consecutive patients with a single lesion

Abstract

Patients with hepatocellular carcinoma (HCC) frequently experience intrahepatic HCC recurrence even after complete ablation of primary lesions. Because the oncogenic process may be different for hepatitis B viral (B-viral) and hepatitis C viral (C-viral) HCC, the present study was conducted to elucidate the factors contributing to HCC recurrence with respect to the infected hepatitis virus. Two hundred thirty-six patients with a single HCC lesion who underwent complete ablation of the tumor by PEIT and/or PMCT or surgical resection at Tokyo University and its affiliated hospitals from 1993 to 1997 were enrolled. The patients were classified into 3 groups: the B-viral group, C-viral group, and NBNC group. After complete removal of tumors, the patients were followed for a mean period of 39 months. The factors contributing to HCC recurrence were analyzed by univariate and multivariate analysis using the Cox proportional hazard model. The rate of intrahepatic recurrence in enrolled patients at 1, 3, and 5 years was 19%, 50%, and 64%, respectively. The intrahepatic recurrence rate in C-viral and B-viral HCC was higher than that in the NBNC-related HCC. Fibrosis staging, pathological grading of HCC, and serum AFP levels were significantly linked to intrahepatic recurrence by univariate analysis, and fibrosis staging was strongest in the multivariate analysis for C-viral HCC (P = .004). In contrast, fibrosis staging did not affect the recurrence in B-viral (P = .51) and NBNC-related (P = .77) HCC. Risk factors for HCC recurrence differed according to the infected viral state.

Risk factors for the recurrence of hepatocellular carcinoma after radiofrequency ablation of hepatocellular carcinoma in patients with hepatitis C

“…RFA is successful for achieving a one-session treatment for patients with small HCC using RFA with CT assistance, and RFA with CT assistance is effective for the treatment of patients with small HCC [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] . One of the advantages of RFA is that it can be repeatedly performed, can be combined with TACE, and can also be used according to the features of the disease and the response [7] .…”

“…Patients with the high level of serum ALT for 2 years or more were at a greater risk of HCC development [17] . Patients with HCV-associated cirrhosis with a sustained high serum ALT level are at a high risk of HCC development, suggesting the possibility of the prevention of HCC development in HCV-associated cirrhosis patients by reducing inflammatory necrosis [13] . Many investigators have shown that patients with cirrhosis who have persistently high ALT levels have a high risk of developing HCC [16,19,20] .…”

Prognostic significance of c‐myc and AIB1 amplification in hepatocellular carcinoma

“…The correlation between clinicopathologic parameters and prognosis for patients with HCC has been studied widely, and several factors, such as IM through the portal vein, cirrhotic staging, pathologic grade, and serum ␣-fetoprotein levels, have been associated with a poor prognosis. 32,33 However, the molecular mechanism of metastasis and recurrence remains unclear. In our large-scale studies, obvious amplification differences between primary HCC and metastatic HCC were detected by the c-myc probe (29% vs. 45%) and the AIB1 probe (23% vs. 41%).…”

Outcome of small liver nodules detected by computed tomographic angiography in patients with hepatocellular carcinoma

“…The rates of intrahepatic recurrence at 1, 3 and 5 years after radical treatment are reported to reach 19, 50 and 64%, respectively [8] and recurrent HCC is a major factor contributing to the poor prognosis. It is possible that some cases of intrahepatic recurrence are due to tiny nodules that cannot be detected by computed tomography (CT) at the time of initial diagnosis.…”