Clinicopathologic features of long-term survivors and disease-free survivors after resection of hepatocellular carcinoma: A study of a prospective cohort

Purpose: This study aims to clarify the clinicopathologic features of long-term survivors and disease-free survivors after resection of hepatocellular carcinoma (HCC). Patients and Methods: The clinicopathologic features of 5-year survivors and disease-free survivors were elucidated in a cohort of 230 patients prospectively observed for > 5 years (64 to 192 months) after curative resection of HCC. Results: The incidence of 5-year overall and disease-free survivors were 37% (85 of 230) and 20% (45 of 230), respectively. Clinicopathologic features associated with 5-year survivors included female sex (P = .024), preoperative serum albumin greater than or equal to 40 g/L (P = .033), AST < 50 u/L (P = .001), tumor < 5 cm (P = .001), solitary tumor (P = .035), encapsulated tumor (P = .021), no venous invasion (P = .001), no microsatellite nodule (P =.001), and early pathologic tumor-nodemetastasis (pTNM) stage (I or II, P < .001). Features favoring 5-year disease-free survivors were preoperative serum AST < 50 u/L (P = .007), tumor < 5 cm (P = .005), encapsulated tumor (P = .007), no venous inversion (P < .001), no microsatellite nodule (P =.001), and early pTNM stage (I or II, P < .001). By multivariate analysis, pTNM stage was the only significant predictive factor for both overall and disease-free survival. Conclusion: This study shows that long-term disease-free survival > 5 years after resection of HCC can be achieved in patients with favorable tumor characteristics. Early pTNM stage was the most reliable predictor of both long-term overall and disease-free survivors. J Clin Oncol 79:3037-3044. (C) 2001 by American Society of Clinical Oncology.