Relationship between period of survival and clinicopathological characteristics in patients with hepatocellular carcinoma who underwent hepatectomy

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Background/Aims: Cancer death in the early period after hepatectomy remains problematic in patients with hepatocellular carcinoma (HCC). We examined the relationship between clinico-pathological 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.