Validation of risk factors affecting the early recurrence of single lesion hepatocellular carcinoma with HBV related liver cirrhosis patients after curative resection

Abstract

Background: Early recurrence is associated with poor prognosis after curative resection for hepatocellular carcinoma (HCC). This study was designed to validate the risk factors affecting the early recurrence of single lesion HCC with HBV related liver cirrhosis (LC) patients. Methods: 132 cases of consecutive HCC patients were enrolled in our institution between Jan 2005 and Dec 2015. We divided the cohort into two groups: early recurrence group(ER) which has recurrence within 12 months after resection, and non-early recurrence group (NER). Survival rate, univariate and multivariate analysis were performed to identify variables associated with early recurrence. Results: The selected cut-off values with sufficient sensitivity and specificity were 1.99 for Neutrophil-to-Lymphocyte Ratio (NLR). When comparing the ER group with NER group, significant differences were observed in the level of PIVKA (p=0.007), NLR (p=0.001), GPS (p=0.001), Edmonson-Steiner (ES) grading (p=0.002), tumor necrosis (p=0.004) and lymphovascular invasion (LVI) (P=0.001). ER groups has statistically significant lower overall survival rate than NER groups (p=0.000). By multivariate analysis, there were significant differences in NLR more than 1.99 (p=0.000), elevated Glasgow Prognostic Score (GPS) (p=0.004) and presence of lympho-vascular invasion (p=0.0002) for affecting the overall survival of the ER group. Conclusion: Preoperative NLR more than 1.99 and elevated GPS and presence of lymphovascular invasion were independent risk factors for ER of single lesion HCC with HBV LC patients after curative resection.