Predictors of early recurrence of hepatocellular carcinoma after hepatic resection in a single Egyptian institute: A retrospective study

Introduction: Liver resection for hepatocellular carcinoma (HCC) can have a recurrence rate of up to 50%. This study aims to define potential factors that can have a role in recurrence of the tumor by defining very early recurrence (VER) in the first 6 months after surgery. Patients and Methods: This retrospective study was conducted on patients who underwent liver resection for HCC in the surgery department at Tanta University over 6 years between 2016 and 2022. Collection of the preoperative, operative and postoperative data of 131 patients that met our criteria including laboratory, radiology and histopathology was done and postoperative complications, recurrence, and overall survival were reported. Analysis of the data available was done to figure out any correlation between these variants and both recurrence (including VER) and survival. Results: There was a significant relation between preoperative alpha-fetoprotein (AFP) and recurrence. Elevation of liver enzymes [alanine transaminase (AST), aspartate aminotransferase (ALT)] was an incident that was recorded after surgery and there was a significant relation between the maximal elevation of AST, ALT, and recurrence. For VER maximum tumor diameter and preoperative AFP were significantly related to VER and also postoperative maximum AST had been shown to have a significant relation with recurrence. Of 131 patients, 92 patients are still alive at the last date of followup and 39 patients are deceased. Age of the patients (mean 68.1 +/- 11 SD) and maximum tumor diameter were found be significant factor in relation with mortality. Conclusion: Within multiple preoperative and operative risk factors beside the criteria of the tumor, our study defined maximum tumor diameter, moderate to poor differentiation of the tumor, Milan criteria, preopertive AFP, postoperative AST, ALT as significant risk factors for recurrence.