Relationship Between Period of Survival and Clinicopathological Characteristics in Patients with Hepatocellular Carcinoma who Underwent Hepatectomy

Background/Aims: Cancer death in the early period after hepatectomy remains problematic in patients with hepatocellular carcinoma (HCC). We examined the relationship between clinicopathological parameters and survival periods in 234 HCC patients who underwent hepatectomy. Methodology: Patients were divided into four groups: Group 1, survival >5 years; Group 2, survival for 2-5 years; Group 3, cancer death at 2-5 years; and Group 4, cancer death in <2 years. Results: Numbers of patients in each subgroup were: Group 1, n=87 (37%); Group 2, n=44 (19%); Group 3, n=46 (20%); and Group 4, n=57 (24%). Child-Pugh B status, blood loss >1500 ml, multiple tumors, tumor size >5 cm, not meeting Milan criteria, irregular macroscopic findings, invasion of Glissonian pedicle, invasion of hepatic vein, higher modified Japan Integrated Staging score (3-5), long-term ascites after hepatectomy and postoperative tumor recurrence within 12 months were frequent in Group 4 (p<0.05). Multivariate analysis revealed AFP level >= 1000 ng/ml (hazard ratio (HR), 2.6) and early tumor relapse (HR, 8.1) as independently related parameters (p<0.05). Conclusions: Careful follow-up for early tumor relapse may be important for improving postoperative outcomes in HCC patients with high preoperative AFP levels.