Prognostic factors and 10-year survival in patients with hepatocellular carcinoma after curative hepatectomy

Abstract

PURPOSE: There were contrary results about the effects of hepatitis B e antigen (HBeAg) positivity on the long-term survival in patients with hepatocellular carcinoma (HCC) after curative resection.

PATIENTS AND METHODS: Medical records of 170 HCC patients who underwent curative liver resections were retrospectively reviewed. The 10-year survival rate and correlations among clinical, laboratory, and pathological data, especially HBeAg, were analyzed.

RESULTS: Fifty-two patients survived more than 10 years. The 10-year actual overall survival (OS) rate was 30.6%, and the actual disease-free survival (DFS) rate was 24.1%. The median OS and DFS were 76 and 35 months, respectively. In multivariate analysis, HBeAg positivity (P = 0.032; hazard ratio [HR], 3.041), presence of a satellite nodule (P = 0.007; HR, 4.166), and elevated ICG R15 (P = 0.003; HR, 4.915) had a significant negative correlation with the 10-year DFS rate. In addition, HBeAg positivity (P = 0.044; HR, 3.725) and recurrence (recur within 1 year, P < 0.001; HR, 41.296; recur after 1 year, P = 0.03; HR, 4.848) were found as independent factors which were negatively correlated to the 10-year OS.

CONCLUSIONS: The presence of HBeAg was significantly correlated to DFS and OS after curative resection for HCC. Active treatment of B viral hepatitis before and after surgery should be provided to prolong survival in patients with 5-10-cm HCC.