Primary hepatocellular carcinoma patients with multiple nodules increased short-term recurrence after radical resection / 中华肝胆外科杂志

ABSTRACT

Objective To investigate the relationship between primary hepatocellular carcinoma (HCC) with multiple nodules and short-term recurrence after radical resection.Methods We retrospectively analyzed the clinical data and follow-up of 692 consecutive HCC patients who underwent curative resection at the Affiliated Hospital of Qingdao University from January 2000 to December 2011.The diagnosis of multiple nodules was based on preoperative imaging data and observations in operation.Results Of 692 HCC patients, 126 patients had multiple nodules (18.2％, the MN group) and 566 patients had a single nodule (71.8％, the SN group).The 1-, 2-, 5-, and 10-year overall survival (OS) rates were 86.5％,72.2％, 38.1％, and 23.2％ for the MN group, and 93.8％, 82.7％, 58.2％, and 35.7％ for the SN group, respectively (P ＜ 0.05).The 1-, 2-, 5-, and 10-year disease-free survival (DFS) rates were 68.6％, 46.8％, 27.2％, and 19.8％ for the MN group, and 80.2％, 62.1％, 42.0％, and 34.6％ for the SN group, respectively (P ＜ 0.05).Cox regression model analysis showed a maximum nodule diameter of ＞ 5 cm was an independent risk factor of short-term recurrence in the MN group.Conclusions The prognosis of HCC patients with multiple nodules after radical resection was poorer and the short-term recurrence rate was significantly higher than those patients with a single-nodule.A maximum nodal diameter of ＞ 5 cm was an independent risk factor of short-term recurrence for patients with multiple nodules after radical resection.Therefore, patients with multiple nodules, especially ＞ 5 cm, should be followed up closely and they are good candidates for a multiple disciplinary team (MDT) treatment.