The prognostic factor for outcome following second resection for intrahepatic recurrence of hepatocellular carcinoma with a hepatitis B virus infection background

Purpose: Second resection has been proved to be a safe and effective treatment for patients with intrahepatic recurrent HCC after primary resection; however, preoperative prognostic factors for outcome following second resection in patients with a hepatitis B virus (HBV) infection background remains to be clarified. Methods: Fifty-seven patients with intrahepatic recurrent an HCC and HBV infection background received second resection from 1997 to 2003 in our institute. All of them were negative for anti-hepatitis C virus (HCV) and positive regarding HBV profile. Patient and tumor factors were analyzed. Results: At the time of preparing this paper, 31 had re-recurrence and 21patients had died. No postoperative mortality was noted. The 1-, 3-, and 5- year overall survival after second resection were 69.9 %, 61.2 %, and 30.6 %, respectively. Univariate and multivariate analysis showed that vascular invasion and time to recurrence were the independent prognostic factors for overall survival following second resection. The 3- and 4-year overall survival after second resection were 57.7 % and 46.6 % in patients with the presence of any of two risk factors (n = 46), and 100 % and 100 % in those with absence of both risk factors (n = 11, P = 0.008). Conclusions: Vascular invasion and time to recurrence were the prognostic factors for overall survival following second resection of intrahepatic recurrent HCC.