A mathematical model to predict short-term recurrence and metastasis of primary hepatocellular carcinoma larger than 10 cm in diameter.

Abstract

BACKGROUND/AIMS: To construct a mathematical model to predict short-term recurrence and metastasis of primary hepatocellular carcinoma (HCC) larger than 10 cm in diameter after radical resection and analyze the influencing factors. METHODOLOGY: A total of 166 patients with primary HCC larger than 10 cm were recruited from January 2002 to December 2010. Univariable and multivariable logistic regression analyses were performed and a mathematic model predicting the recurrence of HCC at different time points was constructed. RESULTS: Univariable analysis showed preoperative serum AFP of ≥1210 ng/mL (X4), intraoperative macroscopic tumor thrombus (X7) and postoperative pathological grade (X11) were related to the recurrence within 6 months after surgery. Preoperative serum AFP of ≥1210 ng/mL (X4) and microscopic tumor thrombus (X10) were associated with the recurrence within 6-12 months after surgery. Multivariable analysis revealed the risk factors of recurrence within 6 months and 6-12 months after surgery included preoperative serum AFP of ≥1210 ng/mL (X4) and intra-operative macroscopic tumor thrombus (X7); those within 6-12 months after surgery were preoperative serum AFP of ≥1210 ng/mL (X4) and microscopic tumor thrombus (X10). CONCLUSIONS: Preoperative serum AFP and blood vessel involvement are risk factors of short-term recurrence/metastasis of huge HCC after surgery. The equation for prediction of HCC recurrence at different time points varies.