Factors affecting prognosis of small hepatocellular carcinoma in Taiwanese patients following hepatic resection

• Published in: Canadian journal of gastroenterology 2011-09, Vol.25 (9), p.485-491
• Main Authors: Ko, Chih-Jan, Chien, Su-Yu, Chou, Chen-Te, Chen, Li-Sheng, Chen, Mei-Ling, Chen, Yao-Li
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Carcinoma, Hepatocellular - blood; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Disease-Free Survival; Female; Hepatitis B Surface Antigens - blood; Humans; Kaplan-Meier Estimate; Liver Neoplasms - blood; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Male; Middle Aged; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Original; Prognosis; Proportional Hazards Models; Serum Albumin - metabolism; Taiwan
• ISSN: 0835-7900
• DOI: 10.1155/2011/790528

Small hepatocellular carcinoma (HCC) affects millions of individuals worldwide. Surveillance of high-risk patients increases the early detection of small HCC. To identify prognostic factors affecting the overall survival (OS) and recurrence-free survival (RFS) of patients with small HCC. The present prospective study enrolled 140 Taiwanese patients with stage I or stage II small HCC. Clinical parameters of interest included operation type, tumour size, tumour histology, Child- Pugh class, presence of hepatitis B surface antigen and liver cirrhosis, hepatitis C status, alpha-fetoprotein, total bilirubin and serum albumin levels, and administration of antiviral and salvage therapies. Tumour size correlated significantly with poorer OS in patients with stage I small HCC (P=0.014); however, patients with stage II small HCC experienced a significantly poorer RFS (P=0.033). OS rates did not differ significantly between patients with stage I and stage II small HCC. Tumour margins, tumour histology and cirrhosis did not significantly affect OS or RFS (P>0.05). Increasing tumour size has generally been associated with poorer prognoses in cases of HCC. The present study verified the relationship between small HCC tumour size and OS; however, a reduction in OS with increasing tumour size was demonstrated for patients with stage I - but not for stage II - small HCC. Patients with stage II small HCC may benefit from aggressive surveillance for tumour recurrence and appropriate salvage treatment. Further studies are needed for additional stratification of stage I patients to identify those at increased risk of death.