Analysis Of Influencing Factors For Hepatocellular Carcinoma Recurrence After Radical Resection

ObjectiveTo explore the characteristics of patients with recurrence of primary hepatocellular carcinoma(HCC)after radical resection,Identify risk factors for postoperative recurrence,provide reference for early assessment of postoperative survival of patients.MethodsSelected patients with hepatocellular carcinoma who visited the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Guangzhou Medical University from January 2016 to December 2021,and all patients with HCC were treated for the first time.Query all patient clinical data through outpatient and inpatient medical record system,Patient data including age,gender,liver function,tumor markers,surgery-related information,postoperative pathological data,immunohistochemistry and other indicators.Postoperative recurrence status of patients was inquired through outpatient follow-up and telephone follow-up.Comparison of postoperative recurrence and non-recurrence characteristics in all patients,univariate and multivariate logistic regression analysis of factors influencing postoperative recurrence of HCC,and build risk prediction models.Results1.Patient data: A total of 117 patients were collected.There were 100 males and17 females,aged 30-84 years,with an average age of(57.6±11.9)years.Hepatitis B was positive in 98 cases and negative in 19 cases.Child-Pugh classification: 81 cases of grade A,36 cases of grade B;79 cases of AFP≤400ng/ml,38 cases of >400ng/ml.2.Follow-up results: The follow-up period was from January 2016 to December2021,and the follow-up time was 1-63 months(the shortest time was 1 month and the longest was 63 months),with an average follow-up time of(39.2±7.3)months.There were 75 cases of liver cancer recurrence or metastasis,accounting for 64.10%,and 42 cases without recurrence or metastasis,accounting for 35.90%.The recurrence rate was 34.19% within 6 months after surgery,13.68% within 7 to 12 months after surgery,7.69% within 13 to 24 months after surgery,and 8.55% within 25 months after surgery.3.Univariate logistic regression analysis showed that low differentiation of hepatocellular carcinoma(P=0.007),incomplete tumor envelope(P=0.000),tumor invasion of bile duct(P=0.027),tumor invasion of large vessels(P=0.000),tumor invasion of microvessels(P=0.000),tumor maximum diameter>5 cm(P=0.002)were risk factors for recurrence of HCC after radical resection.4.Multivariate analysis of COX proportional risk regression model showed that low tumor differentiation(P=0.001),incomplete tumor envelope(P=0.035),tumor invasion of large vessels(P=0.000),tumor invasion of microvessels(P=0.001),and tumor diameter>5 cm(P=0.001)were independent risk factors for recurrence of HCC after radical resection.Conclusions1.Low degree of tumor differentiation,incomplete tumor capsule,tumor invasion of large blood vessels,tumor invasion of microvessels,and tumor diameter >5 cm are independent risk factors for postoperative recurrence of HCC.