Histological subclassification of cirrhosis can predict recurrence after curative resection of hepatocellular carcinoma
Seung Up Kim
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorKyu Sik Jung
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorSarah Lee
Department of Pathology and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorJun Yong Park
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorDo Young Kim
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorSang Hoon Ahn
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea
Brain Korea 21 PLUS Project of Medical Science, Korea
Search for more papers by this authorGi Hong Choi
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorKyung Sik Kim
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorJin Sub Choi
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorKwang-Hyub Han
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea
Brain Korea 21 PLUS Project of Medical Science, Korea
Search for more papers by this authorCorresponding Author
Young Nyun Park
Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
Department of Pathology and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
Brain Korea 21 PLUS Project of Medical Science, Korea
Correspondence
Young Nyun Park, MD, PhD, Department of Pathology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun–gu, Seoul 120-752, Korea
Tel: +82–2–2228–1768
Fax: +82–2–362–0860
e-mail: [email protected]
Search for more papers by this authorSeung Up Kim
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorKyu Sik Jung
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorSarah Lee
Department of Pathology and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorJun Yong Park
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorDo Young Kim
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorSang Hoon Ahn
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea
Brain Korea 21 PLUS Project of Medical Science, Korea
Search for more papers by this authorGi Hong Choi
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorKyung Sik Kim
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorJin Sub Choi
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorKwang-Hyub Han
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea
Brain Korea 21 PLUS Project of Medical Science, Korea
Search for more papers by this authorCorresponding Author
Young Nyun Park
Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
Department of Pathology and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
Brain Korea 21 PLUS Project of Medical Science, Korea
Correspondence
Young Nyun Park, MD, PhD, Department of Pathology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun–gu, Seoul 120-752, Korea
Tel: +82–2–2228–1768
Fax: +82–2–362–0860
e-mail: [email protected]
Search for more papers by this authorAbstract
Background
Recurrence of hepatocellular carcinoma (HCC) after curative resection continues to be a major cause of death. This prospective study is designed to investigate whether histological subclassification of cirrhosis using the Laennec system could predict recurrence in patients with hepatitis B virus (HBV)-related HCC after curative resection.
Methods
Patients with HBV-related HCC who underwent curative resection and showed Laennec stage 3 to 4 were enrolled and the cases with stage 4 were subclassified histologically into three groups (stages 4A, 4B and 4C) according to the Laennec system. Between February 2006 and August 2009, 92 patients were recruited.
Results
Stage 3, 4A, 4B and 4C were identified in 24 (26.1%), 15 (16.3%), 43 (46.7%) and 10 (10.9%) patients respectively. The cumulative incidence rates of recurrence at 1, 2 and 3 years were 24.2%, 40.5% and 55.1% respectively. On multivariate analysis, serum albumin [hazard ratio (HR), 0.528; 95% confidence interval (CI), 0.312–0.891; P = 0.017] and Edmondson–Steiner grade III–IV (HR, 3.456; 95% CI, 1.123–10.517; P = 0.031) were significantly correlated with early recurrence (<1 year), whereas stage 4C (HR, 5.426; 95% CI, 1.030–28.598; P = 0.046) was the only independent risk factor for late recurrence (≥1 year).
Conclusions
Histological subclassification of cirrhosis using the Laennec system is a significant predictor of late recurrence in patients with HBV-related HCC after curative resection.
Supporting Information
| Filename | Description |
|---|---|
| liv12475-sup-0001-FigS1.docxWord document, 9.7 KB | Fig. S1. Recruitment algorithm. A total of 160 consecutive patients with HBV-related HCC undergoing curative resection were recruited. Sixty patients with stage 0–2 were excluded according to our study design. Of the 100 patients with stage 3 or 4, eight were excluded according to our exclusion criteria. Finally, a total of 92 patients were assessed in statistical analyses. HBV, hepatitis B virus; HCC, hepatocellular carcinoma. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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