TY - JOUR T1 - How to Improve the Outcome in Patients with AJCC Stage I Hepatocellular Carcinoma JF - Anticancer Research JO - Anticancer Res SP - 3093 LP - 3103 VL - 34 IS - 6 AU - ANTHONY Q. YAP AU - CARLOS A. MILLAN AU - JING-HOUNG WANG AU - CHIH-CHI WANG AU - SEN-NAN LU AU - SHIH-HO WANG AU - CHIH-CHE LIN AU - YUEH-WEI LIU AU - CHEE-CHIEN YONG AU - WEI-FENG LI AU - TING-LUNG LIN AU - CHAO-LONG CHEN Y1 - 2014/06/01 UR - http://ar.iiarjournals.org/content/34/6/3093.abstract N2 - Aim: Survival of patients with stage I hepatocellular carcinoma (HCC) is higher than in patients with more advanced disease, however many of them will ultimately die of tumor recurrence and liver failure. Our objective focuses on identifying the pathological and clinical factors that could affect disease-free (DFS) and overall survival (OS). In addition we reviewed the treatment offered for recurrence and its impact on OS. Patients and Methods: Between January 1992 and December 2002, a total of 473 patients who underwent hepatectomy for HCC at the Kaohsiung Chang Gung Memorial Hospital were enrolled in this study. Relevant clinicopathological and perioperative variables were subjected to univariate and multivariate analysis. Results: A total of 224 patients with a mean follow-up period of 4.6 years were analyzed. The 1-, 3-, 5-, and 10-year DFS rates were 82.5%, 57.6%, 46.9% and 32.0% respectively. The 1-, 3-, 5-, and 10-year OS rates were 91.5%, 83.0%, 70.1% and 56.3% respectively. The multivariate analysis identified age >50 yeas, Indocyanine Green (ICG) clearance test and cirrhosis as independent factors that negatively impact DFS and age ≥50 years, resection type, presence of complications and tumor recurrence as factors affecting OS. In patients with recurrence (n=130), the factors that negatively impact OS were blood transfusion, age ≥50, blood loss and presence of surgical complications. Conclusion: Meticulous surgical technique is the key to improving the outcome of patients with stage I HCC. The presence of complications was the only modifiable clinicopathological factor that affected the OS in our study. ER -