Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 14, 2011; 17(14): 1889-1894
Published online Apr 14, 2011. doi: 10.3748/wjg.v17.i14.1889
Risk factors for residual tumor after resection of hepatocellular carcinoma
Xiao-Hong Chen, Bo-Heng Zhang, Yin Xin, Zheng-Gang Ren, Jia Fan, Shuang-Jian Qiu, Jian Zhou
Xiao-Hong Chen, Bo-Heng Zhang, Yin Xin, Zheng-Gang Ren, Jia Fan, Shuang-Jian Qiu, Jian Zhou, Liver Cancer Institute and Zhongshan Hospital, Fudan University, Shanghai 20032, China
Author contributions: Zhang BH developed the study concept, aims and initiated the project; Chen XH performed the work described in the study and was responsible for writing the final report; Chen XH and Zhang BH were responsible for data analysis; Xin Y assisted the author in preparing and formatting the paper; Zhang BH supervised the entire research process; Ren ZG provided valuable scientific suggestions; Qiu SJ and Zhou J participated in study design and coordination; Fan J developed the study concept, and provided valuable scientific suggestions; all authors have read and approved the final manuscript.
Correspondence to: Bo-Heng Zhang, MD, PhD, Liver Cancer Institute and Zhong Shan Hospital of Fudan University, 136 Yi Xue Yuan Road, Shanghai 200032, China. zhang.boheng@zs-hospital.sh.cn
Telephone: +86-21-64037181 Fax: +86-21-64037181
Received: August 5, 2010
Revised: September 25, 2010
Accepted: October 2, 2010
Published online: April 14, 2011
Abstract

AIM: To identify the clinicopathological risk factors correlated with residual tumor in hepatocellular carcinoma (HCC) patients after resection.

METHODS: From January 2001 to April 2007, 766 HCC patients who had undergone resection were included in this research. Lipiodol angiography was performed within 2 mo after surgery and followed by post-Lipiodol computed tomography (CT) 4 wk later for all 766 patients to monitor tumor in the remnant liver. Tumor detected within the first 3-mo postoperative period was defined as residual tumor. Patients were divided into 2 groups: disease or disease-free within the first 3 mo after surgery. Risk factors for residual tumor were investigated among various clinicopathological variables.

RESULTS: A total of 63 (8.22%) patients were found to have residual tumor after surgery. Three independent factors associated with residual tumor were identified by multivariate analysis: preoperative serum α -fetoprotein (AFP) level [odds ratio (OR) = 1.68 (95% confidence interval (CI): 1.20-2.36)], tumor size [OR = 1.73 (95% CI: 1.29-2.31)] and microvascular invasion [OR = 1.91 (95% CI: 1.12-3.24)].

CONCLUSION: Residual tumor is related to AFP level, tumor size and microvascular invasion. Patients at high risk should undergo closer follow-up and could be candidates for multimodality therapy.

Keywords: Risk factors; Residual tumor; Hepatocellular carcinoma; Radical resection; Lipiodol angiography