Prognostic factors in patients with HBV-related hepatocellular carcinoma following hepatic resection.

Background: To analyze prognostic factors following hepatic resection in patients with HBV-related hepatocellular carcinoma.

Methods: We retrospectively analyzed 217 patients with HBV-related hepatocellular carcinoma who underwent hepatic resection at our hospital between January 2006 and December 2015. Disease-free survival and overall survival rates were analyzed using the Kaplan-Meier method and the log-rank test. The association between recurrence and survival and various clinicopathological factors, including serum alpha-fetoprotein (AFP) level, platelet count, platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, antiplatelet therapy, antiviral therapy, hepatitis C virus infection, and tumor-related characteristics, were assessed using univariate and multivariate logistic regression analysis.

Results: The 1-, 3-, and 5-year overall survival rates were 91, 84, and 79%, respectively, and the recurrence-free survival rates were 72, 51, and 44%, respectively. High post-operative AFP level (hazard ratio [HR] 1.112, 95% confidence interval [CI]: 1.02-1.21, P  = 0.007), multiple tumors (HR 1.991, 95% CI: 1.11-3.56, P  = 0.021), and no antiviral treatment (HR 1.823, 95% CI: 1.07-3.09, P  = 0.026) were independent risk factors for recurrence. High post-operative AFP level (HR 1.222, 95% CI: 1.09-1.36, P  < 0.001), multiple tumors (HR 2.715, 95% CI: 1.05-7.02, P  = 0.039), and recurrence (HR 12.824, 95% CI: 1.68-97.86, P  = 0.014) were independent risk factors for mortality. No other factors analyzed were associated with outcomes in this patient cohort.

Conclusions: High post-operative serum alpha-fetoprotein level and multiple tumors, but not inflammatory factors, were risk factors for poor prognosis in HBV-related hepatocellular carcinoma patients after resection.