Clinicopathological predictors of poor survival and recurrence after curative resection in hepatocellular carcinoma without portal vein tumor thrombosis.

Many factors associated with long-term outcome in hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) were previously identified. However, those in HCC without PVTT have not been elucidated. This study was designed to define the risk factors of poor post-surgical survival and recurrence in this subgroup of HCC. Medical records and follow-up data of consecutive 152 patients with PVTT-absent HCC underwent curative resection were reviewed. The impacts of clinical and pathological variables on patient survival and recurrence were evaluated by univariate and multivariate analyses. It was shown that Edmondson-Steiner grade, TNM stage, microvascular invasion (MVI), satellite nodule, serum AFP level, tumor size and number were significant for tumor-specific and/or tumor-free survival in univariate analysis. Among them, Edmondson-Steiner grade and TNM stage were of independent significances for both, whereas satellite nodule independently predicted tumor-free survival. In Chi-square test, Edmondson-Steiner grade, TNM stage and MVI were significantly related to overall as well as early recurrence. Stepwise logistic regression identified Edmondson-Steiner grade as the single independent predictor of both. To be summarized, variables that are associated with poor prognosis and recurrence in HCC without PVTT are all tumor-related ones. Of these, differentiation degree might be of particular importance.