Histological subclassification of cirrhosis can predict recurrence after curative resection of hepatocellular carcinoma

Seungup Kim, Kyu Sik Jung, Sarah Lee, Junyong Park, doyoung kim, SangHoon Ahn, Gi Hong Choi, Kyung Sik Kim, Jin Sub Choi, KwangHyub Han, Young Nyun Park

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Background: 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. Methods: 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. Results: 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). Conclusions: Histological subclassification of cirrhosis using the Laennec system is a significant predictor of late recurrence in patients with HBV-related HCC after curative resection.

Original languageEnglish
Pages (from-to)1008-1017
Number of pages10
JournalLiver International
Issue number7
Publication statusPublished - 2014 Jan 1


All Science Journal Classification (ASJC) codes

  • Hepatology

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