SIGNIFICANT INFLUENCE OF ACCOMPANYING CHRONIC HEPATITIS STATUS ON RECURRENCE OF HEPATOCELLULAR-CARCINOMA AFTER HEPATECTOMY - RESULT OF MULTIVARIATE-ANALYSIS

Objective The aim of this study was to evaluate the correlation betwee n the histologic status of accompanying chronic hepatitis and the recu rrence rate of hepatocellular carcinoma (HCC) after hepatectomy by mul tivariate analysis. Summary Background Data Recent studies have sugges ted that a considerable number of intrahepatic recurrence of HCC after hepatectomy might be the results of metachronous multicentric hepatoc arcinogenesis. The authors hypothesized that the incidence of recurren ce due to metachronous multicentric hepatocarcinogenesis would depend on the histologic status of accompanying chronic Viral liver disease, which is a main promoter of HCC. Methods One hundred ten patients with HCC who underwent curative resection were studied. Histologic status of accompanying chronic hepatitis was classified into the three catego ries: 1) normal liver or chronic persistent hepatitis (CPH, n = 13), 2 ) chronic aggressive hepatitis (CAH, n = 50), and 3) liver cirrhosis ( LC, n = 47). Results The Cox multivariate proportional hazard model sh owed that the accompanying chronic viral hepatitis status (p = 0.0133) , extent of hepatectomy (p = 0.0078), and number of tumors (p = 0.0475 ) were significantly predictive variables for recurrence-free survival . By the log-rank test, recurrence-free survival rate in patients with CPH was significantly higher than those in patients with CAH (p = 0.0 005) and LC (p = 0.0075). Patients with CAH had the lowest recurrence- free survival rate (vs. LC, p = 0.028). Conclusions The results of thi s study indicated the significant influence of histologic activity of hepatitis on recurrence of HCC. This might support the concept of sign ificant contribution of multicentric hepatocarcinogenesis to recurrenc e of HCC after hepatectomy.