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Clinicopathologic Features of Long-Term Survivors and Disease-Free Survivors After Resection of Hepatocellular Carcinoma: A Study of a Prospective Cohort

From the Center for Study of Liver Disease, Departments of Surgery and Pathology, University of Hong Kong Medical Center, Queen Mary Hospital, Hong Kong, China.

Address reprint requests to Ronnie Tung-Ping Poon, MS, FRCS (Edin), Department of Surgery, Queen Mary Hospital, 102 Pokfulam Rd, Hong Kong, China; email: poontp{at}hkucc.hku.hk

PURPOSE: This study aims to clarify the clinicopathologic features of long-term survivors and disease-free survivors after resection of hepatocellular carcinoma (HCC).

PATIENTS AND METHODS: The clinicopathologic features of 5-year survivors and disease-free survivors were elucidated in a cohort of 230 patients prospectively observed for > 5 years (64 to 192 months) after curative resection of HCC.

RESULTS: The incidence of 5-year overall and disease-free survivors were 37% (85 of 230) and 20% (45 of 230), respectively. Clinicopathologic features associated with 5-year survivors included female sex (P = .024), preoperative serum albumin 40 g/L (P = .033), AST < 50 u/L (P = .001), tumor < 5 cm (P = .001), solitary tumor (P = .035), encapsulated tumor (P = .021), no venous invasion (P = .001), no microsatellite nodule (P = .001), and early pathologic tumor-node-metastasis (pTNM) stage (I or II, P < .001). Features favoring 5-year disease-free survivors were preoperative serum AST < 50 u/L (P = .007), tumor < 5 cm (P = .005), encapsulated tumor (P = .007), no venous invasion (P < .001), no microsatellite nodule (P = .001), and early pTNM stage (I or II, P < .001). By multivariate analysis, pTNM stage was the only significant predictive factor for both overall and disease-free survival.

CONCLUSION: This study shows that long-term disease-free survival > 5 years after resection of HCC can be achieved in patients with favorable tumor characteristics. Early pTNM stage was the most reliable predictor of both long-term overall and disease-free survivors.

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