Effect of Primary Tumor Location on Postoperative Recurrence for Patients with Hepatocellular Carcinoma

Objective To explore the effect of primary tumor location or combined with serum AFP on the prognosis and postoperative recurrence for patients with hepatocellular carcinoma. Methods A total of 256 patients,who underwent routine surgery and with long term follow-up from March 2005 to October 2009,were retrospectively analyzed in our study.Kaplan-Meier survival curve was used to analyze overall survival(OS) and time to recurrence(TTR) and Logrank test was used to calculate P values.Univariate and multivariate analysis of clinicopathological parameters in hepatocellular carcinoma(HCC) patients with postoperative recurrence were carried out by Cox-regression analysis. Results There was different in overall survival of HCC patients based on their primary tumor location(P=0.022).Furthermore,the group with left or double hepatic lobe tumor demonstrated a higher recurrence risk than that of patients in the group with right hepatic lobe tumor(P=0.002).In a stratified analysis,there was a significant difference in the postoperative recurrence rate under the subset of negative serum AFP(AFP<25 ng/ml)(P<0.001),whereas no difference in the subset of positive serum AFP(AFP≥25 ng/ml)(P=0.258).Univariate and multivariate analysis showed that metastasis,serum AFP and Portal vein tumor thrombus(PVTT) were 3 dependent recurrent risk factors,whereas primary tumor location was not. Conclusion Primary tumor location can be served as an important recurrent risk factor in HCC patients after hepatectomy.