Hepatitis viral status affects the pattern of intrahepatic recurrence after resection for hepatocellular carcinoma

Eur J Surg Oncol. 2003 Apr;29(3):266-71. doi: 10.1053/ejso.2002.1395.


Aim: To define whether the patterns of intrahepatic recurrence after resection for hepatocellular carcinoma differ according to hepatitis viral status.

Methods: One hundred and eleven patients undergoing a curative resection for hepatocellular carcinoma were divided into three groups: the C-viral group (n=55), which tested positive for hepatitis C antibody; the B-viral group (n=32), which tested positive for hepatitis B surface antigen; and the non-B non-C (NBNC) group (n=24), which tested negative for both hepatitis B surface antigen and hepatitis C antibody. The long-term outcomes were analyzed retrospectively.

Results: The pattern of development of intrahepatic recurrence differed between the NBNC group and the other groups: the cumulative probability of intrahepatic recurrence reached a plateau at 2.4 years after resection in the NBNC group, while it continued to increase steadily in the hepatitis viral groups. The C-viral group showed a higher incidence of intrahepatic recurrence than the other groups by univariate (P=0.0306) and multivariate (relative risk=1.69, P=0.0429) analyses. Multiple intrahepatic recurrent lesions were more common in the C-viral group (P=0.0457).

Conclusions: Multicentric carcinogenesis in the remnant liver was less common in the NBNC group than in hepatitis viral groups. Hepatitis C virus infection is a significant risk factor for intrahepatic recurrence after resection and is also associated with multiple intrahepatic recurrent lesions.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Analysis of Variance
  • Carcinoma, Hepatocellular / surgery
  • Carcinoma, Hepatocellular / virology*
  • Chi-Square Distribution
  • Female
  • Hepatitis B / complications*
  • Hepatitis C / complications*
  • Hepatitis E / complications*
  • Humans
  • Liver Neoplasms / surgery
  • Liver Neoplasms / virology*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Prognosis
  • Proportional Hazards Models
  • Risk Factors
  • Survival Analysis