Analysis Of Early Risk Recurrence Factors Of 44 Patients With Small Hepatocellular Carcinoma After Hepatectomy

Objective:To investigate the risk factors of early recurrence associated small hepatic carcinoma after radical resection, and to provide a theoretical basis for clinical prevention and early treatment of early recurrence of small hepatocellular carcinoma after operation.Methods: A retrospectiveanalysis of data from liver cancer patients which were hepatectomized in the 1st affiliated hospital of Wannan Medical College during January 2012- December 2013. The screening criteria is as follow:(1) primary hepatocellular carcinoma was the first discovered and the tumor diameter was between 2 cm and 5 cm;(2) There were no distant metastasis via lymph nodes and no other organ cancer observed before operation;(3) No other treatment before operation;(4) Preoperative liver function of patients was dropped into Child-Pugh grade A or grade B with partial good liver function;(5) The operation were performed with the regular hepatectomy and/or irregular hepatectomy. Total of 44 cases with small primary liver cancer in conformity with the standards were selected. Postoperative follow-up is from the first day of after operation to last one year. The standard of postoperative early recurrences is as following: the patients, who were recurred in less than year after the operation, were recruited in the early recurrence group,a total of 14 cases were recruited; a total of 30 cases, who were no recurred were dropped into control group,. In the study, total of 14 indexes were analyzed, including age, gender, tumor diameter(cm), tumor differentiation grade, liver function classification, mode of operation, preoperative Alpha-fetoprotein(AFP) level,tumor capsule, blood loss(ml), perioperative blood transfusion(ml), microvascular invasion, hepatitis B surface antigen(HBV), alkaline phosphatase(ALP) level, γ-glutamyl transpeptidase(GGT) levels. The risk factors of early recurrence after radical resection of small hepatocellular carcinoma were analyzed by logistic regression analysis. Early effects of survival after radical resection of small hepatocellular carcinoma were analyzed by Kaplan-Meier factor analysis method and Multivariate survival after radical resection of small hepatocellular carcinoma were analyzed by Cox stepwise regression analysis.Results: After univariate logistic regression analysis, the result showed that five factors as risk factors might affect the early recurrence,including tumor diameter, pathologic grading of cancer, microvascular invasion, γ-glutamyl transpeptidase( GGT) and perioper-ative blood transfusion(P<0.05). Multivariate logistic regression analysis showed that microvascular invasion factor impact on the early recurrence, and there was a statistically significant difference(P<0.05).After analyzing with the Kaplan-Meier method,Log-rank test in parallel for univariate survival analysis, the results showed that tumor diameter, microvascular invasion, γ-glutamyl transpeptidase(GGT), perioperative blood transfusion, pathologic grading of cancer might affect the disease-free survival period, there have significantly statistical differences(P<0.05). Finally, multivariate survival analysis was performed with Cox regression model, the data showed that the microvascular invasion factor mightaffect the disease-free survival period, and there has a statistically significant difference(P<0.05).Conclusion: tumor diameter, pathologic grading of cancer, microvascular invasion, γ-glutamyl transpeptidase(GGT) and perioperative blood transfusion were the major risk factors forsmall PLC recurrence. Moreover, microvascular invasion was the major risk factor that affect the disease-free survival period.