Analysis Of Related Factors Of Intrahepatic Recurrence Pattern After Curative Resection For Hepatocellular Carcinoma

Objective: To investigate the related factors of intrahepatic recurrence pattern after radical resection of hepatocellular carcinoma and compare the efficacy of different treatment modalities.Methods:The clinical data of 157 hepatocellular carcinoma patients who had intrahepatic recurrence after curative resection were collected from Department of Hepatobiliary Surgery of the First Affiliated Hospital of Fujian Medical University from January 2006 to December July 2014. Intrahepatic recurrence were classified into 3 patterns: type Ⅰ with a lesion(n=79), type II with 2-4 lesions(n=44), and type III with > or =5 lesions(n=34). The clinicopathological factors of the three groups were analyzed by the logistic regression model of SPSS 20. 0 statistical software package for univariate analysis and multivariate analysis, in order to find the related factors influencing the recurrence pattern of hepatocellular carcinoma, and exploring the relationship between the recurrence pattern and the recurrence time, and to observe the efficacy of different recurrence pattern.Resultes: 1.The type Ⅲ was 67.6% in 1 year, the type Ⅰ was 75.0% after 2 years, the recurrence pattern was significant difference in recurrence time(P<0.050). 2.Univariate analysis showed that drinking history, HBV-DNA, tumor size, tumor capsule and pathological differentiation were the risk factors of type Ⅲ(P <0.050); multivariate analysis showed that drinking history, HBV-DNA, tumor capsule and pathological differentiation were the independent risk factors of type Ⅲ(P <0.050). Drinking history was an independent risk factor of typeⅡ and type Ⅲ(P <0.050). 3.The overall 1-, 3-, and 5-year disease-free survival rates of type Ⅰwere 44.9%, 12.8%and 2.6%. The overall 1- and 3-year disease-free survival rates of type Ⅱwere 37.8% and 2.7%. The overall 1-year disease-free survival rate of type wⅢ as 22.0%. 4.The overall 1-, 3-, and 5-year survival rates of type Ⅰwere 88.3%, 69.2% and49.7% respectively,with a median survival time of 49 months. The overall 1-, 3-, and 5-year survival rates of type Ⅱwere 70.3%,30.3% and 29.1% respectively,with a median survival time of 18 months. The overall 1-, 3-, and 5-year survival rates of type Ⅲ were 34.1%, 19.5% and 9.8% respectively, with a median survival time of 5 months. 5.The 1-, 3-, and 5-year survival rates after reoperation were 89.7%,64.4% and 44.6% respectively with a median survival time of 49 months. The 1, 3, and 5-year survival rates after radiofrequency ablation were 96.6%, 72.8% and 72.8% respectively with a median survival time was 63 months. The 1, 3, and 5-year survival rates after TACE were 54.2%, 26.7% and 12.1% respectively with a median survival time was 14 months. The 1, 3, and 5-year survival rates after conservative treatment were 47.1%, 16.1% and 8.1% respectively with a median survival time was 11 months.Conclusion: 1.The independent risk factors of intrahepatic multiple recurrence were drinking history, HBV-DNA, tumor capsule and pathological differentiation. 2.The disease-free survival time after radical resection of hepatocellular carcinoma was negatively correlated with the number of lesions, and the survival time after recurrence was negatively correlated with the number of lesions. 3.Active treatment could significantly improve the prognosis of hepatocellular carcinoma patients with intrahepatic recurrence after radical resection.