LAUSR

Early recurrence (ER) is a strong predictor of poor prognosis in patients with hepatocellular carcinoma (HCC) after hepatectomy. The aim of this study was to examine manageable factors associated with ER. Overall, 475 consecutive patients with primary HCC who underwent curative hepatectomy were included (R0/R1). We defined ER as recurrence within 2 years after hepatectomy and analyzed predictors for ER. We also defined postoperative complication as Clavien-Dindo classification grade III or IV. ER after hepatectomy was observed in 209 cases (44.0%). Patients with ER had a significantly poor prognosis compared with those with late recurrence (log-rank p < 0.0001) and were more likely to be diagnosed with extrahepatic metastasis (p = 0.009). Significant predictors for ER were des-γ-carboxyprothrombin > 40 mAU/mL (odds ratio (OR) 2.06, 95% confidence interval (CI) 1.36–3.14, p = 0.001), multiple tumors (OR 2.80 95%CI 1.83–4.32, p < 0.0001), cirrhosis (OR 1.53, 95%CI 1.01–2.32, p = 0.043), and postoperative complications (OR 1.72, 95% CI 1.05–2.85, p = 0.032). Blood loss (OR 1.09, 95%CI 1.05–1.13, p < 0.0001) and cirrhosis (OR 1.74, 95%CI 1.05–2.86, p = 0.031) were significant predictors for postoperative complications. We should pay close attention to surgical associated- and disease-specific factors in hepatectomy for HCC to prevent ER.