Analysis of risk factors of recurrence in patients with BCLC 0-A hepatocellular carcinoma after surgical resection

Objective: To analyze the risk factors of recurrence in patients with Barcelona Clinic Liver Cancer (BCLC) 0-A hepatocellular carcinoma (HCC) after surgical resection.

Methods: Retrospective analyses were conducted for 218 patients undergoing surgical resection for BCLC 0-A HCC. A total of 17 clinicopathologic factors possibly influencing the recurrence and survival were selected. And multivariate analysis of these parameters was performed with Cox proportional hazard model. Survival analysis was performed with the Kaplan-Meier method.

Results: The overall 1, 3, 5-year survival rates were 95.9%, 85.3% and 67.6% respectively. The median survival from time of primary resection was 35 months. The overall 1, 3 and 5-year disease-free survival (DFS) rates were 84.4%, 56.5% and 47.0% respectively. Univariate analysis showed that cirrhosis, positive alpha-fetoprotein (AFP), satellite nodules, involvement of hepatic capsule, tumor differentiation and microvascular invasion were associated with recurrence. And Cox multivariate analysis showed that satellite nodules, involvement of hepatic capsule and microvascular invasion were the independent risk factors for recurrence.

Conclusions: Surgical resection is a first option for BCLC 0-A HCC. Satellite nodules, involvement of hepatic capsule and microvascular invasion are independent risk factors for recurrence. Postoperative transarterial chemoembolization does not benefit the survival of patients with risk factors of recurrence.