Virologic and biochemical changes and prognosis after liver resection for hepatitis B virus-related hepatocellular carcinoma

Background/Aims: During the natural course of hepatitis B virus (HBV) infec tion, clearance of HE e antigen (HBeAg) and HE surface antigen (HBsAg) occu rs with remission of liver disease. We investigated the effects of postoper ative changes in virologic and biochemical parameters on the prognosis afte r liver resection for HBV-related hepatocellular carcinoma (HCC). Methods: We investigated the relationship between postoperative changes in virologic and biochemical parameters and the incidence of intrahepatic recurrence an d the outcome during a 3-year period following surgery in 30 HCC patients w ith HBsAg. Results: The incidence of intrahepatic recurrence of HCC was sig nificantly higher in patients with acute postoperative exacerbation of hepa titis (p = 0.0084), a sustained high serum concentration of HBV DNA (greate r than or equal to5.0 mEq/ml, p = 0.001), and sustained expression of HBsAg after surgery (p = 0.0421). A high serum concentration of HBV DNA was sign ificantly associated with a shorter survival time (p = 0.0447) and the caus e of death was recurrence of HCC, Conclusion: Patients with acute postopera tive exacerbation of hepatitis, sustained HBsAg expression, and sustained h igh serum concentrations of HBV DNA after surgery may require more intensiv e postoperative monitoring for HCC recurrence. Copyright (C) 2001 S. Karger AG,Basel.