Presence of fibrosis is predictive of postoperative survival in patients with small hepatocellular carcinoma.

BACKGROUND/AIMS: The aim of this study was to evaluate whether liver fibrosis is predictive of survival in patients who require hepatectomy for small hepatocellular carcinoma.

METHODOLOGY

In this retrospective study, we enrolled 174 patients with small HCC who underwent major or minor hepatectomy at the Changhua Christian Hospital during the period January 2001 to June 2007. Patients were classified into two subgroups depending on whether tumor recurrence after surgery. Factors influencing overall survival and recurrence were analyzed and compared between the two subgroups. Univariate and multivariate logistic regression analyses were performed to determine the most significant predictors of tumor recurrence or death. The Kaplan-Meier method and the log-rank test were used to detect differences in cumulative survival between the two subgroups based on histopathologic fibrosis scores.

RESULTS

Results of the univariate analysis revealed these variables that tumor margin, type of resection, and degree of fibrosis were independent predictors of tumor recurrence or death. However, the multivariate analysis revealed that fibrosis was the only independent predictor of tumor recurrence. Survival analysis showed that low fibrotic scores were predictive of disease-free survival.

CONCLUSIONS

The degree of fibrosis is an important predictor of survival among patients who undergo hepatectomy for small HCC.