Seung Up Kim and Kyu Sik Jung have equally contributed to this work.
Cirrhosis and Liver Failure
Histological subclassification of cirrhosis can predict recurrence after curative resection of hepatocellular carcinoma
Article first published online: 3 MAR 2014
© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Volume 34, Issue 7, pages 1008–1017, August 2014
How to Cite
Liver Int. 2014: 34: 1008–1017
- Issue published online: 17 JUL 2014
- Article first published online: 3 MAR 2014
- Accepted manuscript online: 1 FEB 2014 06:32AM EST
- Manuscript Accepted: 26 JAN 2014
- Manuscript Received: 14 JUL 2013
- Liver Cirrhosis Clinical Research Center
- Ministry of Health and Welfare. Grant Numbers: A102065, A120631
- Yonsei University College of Medicine. Grant Number: 6-2011-0145
- chronic hepatitis B;
- hepatitis B virus;
- hepatocellular carcinoma;
- laennec staging;
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.
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.
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).
Histological subclassification of cirrhosis using the Laennec system is a significant predictor of late recurrence in patients with HBV-related HCC after curative resection.