Analysis Of Related Factors Of Recurrence Type After Curative Resection Of Hepatocellular Carcinoma

Objective: To explore the influencing factors of recurrence type after curative resection of hepatocellular carcinoma(HCC). Methods: Collected the clinical datas of 197 patients from liver surgery in department of liver disease center of the first affiliated hospital of FuJian medical university from September 2003 to December 2008,who has complete follow-up data for the first curative resection of hepatocellular carcinom, including 96 patients of postoperative intrahepatic recurrence.According to the site is divided into three groups:group of the same side lobe recurrence, group of the contralateral lobe recurrence, group of diffuse recurrence. Statistical analysis the three groups patients’ age, gender, whether with hepatitis B infection, preoperative serum HBV-DNA levels, preoperative serum alanine aminotransferase(ALT), preoperative serum alphafetoprotein(AFP), tumor size, tumor capsular whether complete, whether to have the microscopic vascular tumor emboli, pathological differentiation degree for,using the logistic regression model of SPSS 21. 0 statistical software package for single and multiple factors analysis, studying the related factors influencing the recurrence type of hepatocellular carcinoma, and exploring the relationship between the type and the time of recurrence. Resultes: 1. The intrahepatic recurrence rate was 31.97%, 51.27% and 58.88% in the 1st, 3nd, 5th year after curative resection of HCC. Postoperative recurrence type: the same side lobe recurrence, the contralateral lobe recurrence,diffuse recurrence respectively were 42 cases(43.75%), 22 cases(22.92%) and 32 cases(33.33%). 2. There was significant difference in the tumor size,whether have the microscopic vascular tumor emboli, preoperative serum AFP of the hree groups(P<0.05). 3. Logistic single factor analysis prompt that preoperative serum AFP is the influence factor of the same side lobe recurrence, whether have microscopic vascular tumor emboli is the influence factor of the same side lobe recurrence, diffuse recurrence; Logistic multifactor analysis prompt that preoperative serum AFP is the independent risk factor for the same side lobe recurrence, whether have microscopic vascular tumor emboli is the independent risk factor for diffuse recurrence. 4. Logistic multi-factor analysis prompt that preoperative serum AFP is the independent risk factor for the same side lobe recurrence, preoperative serum ALT is the independent risk factor for diffuse recurrence in the small hepatocellular carcinoma group(size ≤5 cm). 5. The diffuse recurrence account for 45% within 2 years, the same side lobe recurrence account for 58.3% after 2 years, there was significant difference between the type and the time of recurrence(P<0.05). Conclusion: 1. The intrahepatic recurrence type after curative resection of hepatocellular carcinoma has related with patients’ tumor size, whether to have the microscopic vascular tumor emboli, preoperative serum AFP. 2. The same side lobe recurrence after curative resection of hepatocellular carcinoma was associated with preoperative serum AFP level, diffuse recurrence was associated with microscopic vascular tumor emboli. 3. Early recurrence(≤2 years) was given priority to diffuse recurrence, the late recurrence(>2 years) was given priority to the same side lobe recurrence.