Does surgical resection of hepatocellular carcinoma accelerate cancer dissemination

Table 1 Demographic data including clinical and tumor vari-ables of patients with HCC undergoing curative resection (n = 81)

Variables		No. of patients (%)
Age (mean, years)		52 ± 13
Male		42(52)
Cirrhosis		56(69)
Child- Pugh’s class A		70(86)
HBsAg (+)		62(77)
Anti-HCV (+)		31(38)
Serum AFP < 20 ng/ml		29(36)
	20-103 ng/ml	29(36)
	> 103 ng/ml	23(28)
Size of HCC < 3 cm		25(30)
	3-10 cm	28(35)
	> 10 cm	28(35)
Complete capsule		28(35)
Daughter nodules		32(40)
Vascular permeation		(46)37
Edmondson-Steiner’s grade I		6(7)
	grade II	36(44)
	grade III	26(32)
	grade IV	13(16)

AFP: serum alpha fetoprotein, HBsAg(+): positive hepatitis B surface antigen, Anti-HCV(+): positive hepatitis C virus antibody, Edmondson and Steiner grade: differentiation grades I, II, III, and IV.

Table 2 Correlation among timing of blood sample collection and circulating tumor cell status and postoperative recurrence

Group	Preoperation(baseline)	Perioperation (within12 hours after surgery)	Postoperation(90 days after surgery)	Numberof patients	Patient numberof recurrence (%)
1.	Positive	Positive	Positive	9	8（88.9）
2.	Positive	Positive	Negative	3	2（66.7）
3.	Positive	Negative	Positive	2	0（100）
4.	Positive	Negative	Negative	8	0（0）
5.	Negative	Positive	Positive	5	4（80）
6.	Negative	Positive	Negative	7	0（0）
7.	Negative	Negative	Positive	3	3（100）
8.	Negative	Negative	Negative	44	17（38.6）
Overall	Negative			81	36（44.4）

Table 3 Predictors of HCC recurrence

Variables	P values
	UV	MV
Sex	0.274	-
Age	0.842	-
Liver cirrhosis	0.019	-
HBsAg (+)	0.505	-
Anti-HCV (+)	0.622	-
Serum AFP	< 0.001	-
Child-Pugh class	0.087	-
Size (< 3 cm, > 10 cm)	0.140	-
Capsule	< 0.001	n.s.
Daughter nodules	< 0.001	n.s.
Vascular permeation	< 0.001	0.023
Edmondson Steiner grade	< 0.001	0.007
Preoperative hAFP mRNA(+)	0.280	-
Preioperative hAFP mRNA(+)	0.093	-
Postoperative hAFP mRNA(+)	< 0.001	0.067

UV: univariate analysis, MV: multivariate analysis, AFP: se-rum alpha fetoprotein, HBsAg(+): positive hepatitis B surface antigen, Anti-HCV(+): positive hepatitis C virus antibody, Edmondson and Steiner grade: differentiation grades I, II vs. III, IV, n.s.: not significant.

Table 4 Correlation between variables and recurrence related mortality

Variables	P values
	UV	MV
Sex	0.815	-
Age	0.930	-
Liver cirrhosis	0.039	n.s.
HBsAg (+)	0.835	-
Anti-HCV (+)	0.548	-
Serum AFP	< 0.000	-
Child-Pugh class	0.092	-
Size (< 3 cm, > 10 cm)	0.274	-
Capsule	0.004	n.s.
Daughter nodules	0.004	n.s.
Vascular permeation	< 0.001	n.s.
Edmondson Steiner grade	< 0.001	0.057
Preoperative hAFP mRNA (+)	0.728	-
Perioperative hAFP mRNA (+)	0.835	-
Postoperative hAFP mRNA (+)	< 0.001	0.017

UV: univariate analysis, MV: multivariate analysis, AFP: se-rum alpha fetoprotein, HBsAg (+): positive hepatitis B surface antigen, Anti-HCV(+): positive hepatitis C virus antibody, Edmondson Steiner grade: differentiation grades I, II vs III, IV, n.s. :not significant.