간세포암의 절제술 후 재발에 영향을 미치는 인자

Abstract

Purpose: The prognosis of advanced hepatocellular carcinoma (HCC) is very grave. The most effective method to improve the survival rate of HCC patients is early diagnosis and curative resection. The aim of this study is to investigate risk factors affecting the recurrence of HCC after curative resection. Methods: We retrospectively analyzed 287 HCC patients who underwent surgical resection at Severence Hospital between Jan. 1998 and Dec. 2003. They consisted of 222 males and 65 females whose median age was 52 years. Results: Overall survival rates of 1, 3 and 5 year were 91, 71 and 64%, respectively, and overall disease free survival rates of 1, 3 and 5 year were 68, 48 and 29%, respectively. In univariate analysis, HBeAg, HBsAg, indocyanine green retention rate at 15 minutes (ICG-R15), microvascular invasion, tumor number, tumor size, satellite nodule, pathologic T stage (pT stage) and preoperative transarterial chemoembolization (TACE) were factors affecting the recurrence of primary HCC after curative resection. In multivariate analysis, HBeAg was the most important factor for recurrence and tumor size also had statistical significance. Conclusion: We concluded that knowledge of risk factors for postoperative recurrence provides a basis for logical approaches to prevention. The long-term prognosis after resection of HCC remains unsatisfactory as a result of a high incidence of recurrence. Prevention and effective treatmentof recurrence are the most important strategies to improve the long-term survival results of HCC. And prospective studies about antiviral therapy for HBV are required to prevent recurrence of HCC.