Risk factors and outcome of early recurrence after resection of small hepatocellular carcinomas

BACKGROUND: This study aimed to clarify risk factors for early recurrence and examine the subsequent Outcome in patients undergoing potentially R0 resection of small hepatocellular carcinomas (HCCs) (<= 52 cm in greatest dimension). METHODS: Eighty-nine patients were divided into 2 groups as follows: 26 patients suffering from recurrence within 2 years of surgery (early recurrence group) and 63 patients who were disease-free for at least 2 years (disease-free 2Y group). RESULTS: Only 7 of 63 patients (11%) from the group that was disease-free for at least 2 years died during the 5-year period after surgery, whereas 13 of 26 patients (50%) from the early recurrence group died. Multivariate analysis showed that the preoperative maximum removal rate of technetium-99m-diethylenetriamine pentaacetic acid-galactosyl human serum albumin and microscopic vascular invasion were independent predictors of the early recurrence of small HCC. CONCLUSIONS: Early recurrence of small HCC is the leading cause of death within 5 years after R0 resection. The preoperative hepatic functional reserve influences early recurrence, even in patients with small tumors. (C) 2009 Published by Elsevier Inc.