Risk factors for early postoperative recurrence in single and small hepatitis B virus-associated primary hepatocellular carcinoma

Abstract

Objective: To investigate the risk factors of early postoperative recurrence in patients with single and small (≤3 cm) hepatitis B virus-associated primary hepatocellular carcinoma (HBV-HCC).

Methods: This retrospective study analyzed patients with single and small HBV-HCC. All patients were followed up for 1 year after surgery.

Results: Among 182 patients, 54 patients had early recurrence within 1 year. The recurrence group had higher proportions of men, drinking history, Child-Turcotte-Pugh (CTP) class C, patients who underwent transarterial chemoembolization (TACE), and serum alpha-fetoprotein (AFP) >10 ng/mL as well as higher gamma-glutamyl transpeptidase (GGT) levels and lower total protein (TP) and CD8⁺ T lymphocyte levels than the no recurrence group. Cox multivariate regression analysis demonstrated that drinking history (HR, 1.312; 95% CI, 1.042-1.652), CTP class C (HR, 1.236; 95% CI, 1.037-1.473), TACE treatment (HR, 1.241; 95% CI, 1.026-1.501), GGT (HR, 1.138; 95% CI, 1.042-1.243), TP (HR, 0.729; 95% CI, 0.555-0.957), and AFP (HR, 2.519; 95% CI, 1.343-4.726) were independently associated with early postoperative recurrence.

Conclusion: Drinking history, CTP class C, TACE, serum AFP, GGT, and TP levels were independently associated with early postoperative recurrence in patients with single and small HBV-HCC.

Keywords: Child–Turcotte–Pugh; Hepatitis B virus; alpha-fetoprotein; drinking history; gamma-glutamyl transpeptidase; primary hepatocellular carcinoma; prognosis; recurrence; total protein; transarterial chemoembolization.

Figure 1.

Flowchart of this study.

Figure 2.

Drinking history, CTP class, AFP levels, and treatment methods were associated with early recurrence of single and small HBV-HCC. The Kaplan–Meier method was used to draw the cumulative recurrence free survival and the differences were compared between groups using the log-rank test. (a) Drinking history, (b) CTP class, (c) AFP level, and (d) Treatment method. CTP, Child–Turcotte–Pugh grade; AFP, α-fetoprotein; HBV, hepatitis B virus; HCC, hepatocellular carcinoma.