Risk factors for recurrence after curative resection of hepatitis C-related hepatocellular carcinoma in patients without postoperative interferon therapy

Aim: Hepatitis C (HC)-related hepatocellular carcinoma (HCC; HC-HCC) is highly recurrent. Methods: From 1995-2007, 183 curative hepatic resections for primary solitary HC-HCC without postoperative interferon therapy were included in this study. The patients were divided into three groups: (i) 2cm or less (n=56); (ii) more than 2cm to less than 5cm (n=79); and (iii) 5cm or more (n=48). Independent risk factors for HC-HCC recurrence for each group were determined. Results: Independent risk factors for recurrence were aspartate aminotransferase or alanine aminotransferase (AST/ALT) of 80IU/L or more (hazard ratio [HR], 2.1; P=0.02) in patients with HCC of 2cm or less, des-γ-carboxy prothrombin of 100mAU/mL or more (HR, 2.5; P=0.02) and AST/ALT of 80IU/L or more (HR, 2.1; P=0.04) in patients with HCC of more than 2cm to less than 5cm, and the presence of macroscopic portal vein tumor thrombus (HR, 2.8; P=0.02) and AST/ALT of 80IU/L or more (HR, 2.1; P=0.04) in patients with HCC of 5cm or more. All 13 late recurrences of 1 year or more after hepatic resection (27.1%) in patients with HCC of 5cm or more were accompanied by AST/ALT of 80IU/L or more. Conclusion: AST/ALT of 80IU/L or more is an independent risk factor for the recurrence of primary solitary HC-HCC after curative resection irrespective of the primary HC-HCC size.