{'fraction_non_alphanumeric': 0.041723666210670314, 'fraction_numerical': 0.028727770177838577, 'mean_word_length': 4.995901639344262, 'pattern_counts': {'":': 0, '<': 2, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Predictors of poor prognosis by recurrence patterns after curative hepatectomy for hepatocellular carcinoma in Child-Pugh classification A.

BACKGROUND/AIMS
The prevention of recurrence is important for improving long-term outcome for HCC. To identify candidates for postoperative adjuvant therapy after curative hepatectomy for HCC in Child-Pugh classification A (Child A).


METHODOLOGY
Of 157 patients who underwent initial hepatectomy for Child A HCC, 93 had recurrence and were divided into 2 groups: group A, ≤2 tumors, each <3 cm in size at the time of intrahepatic recurrence; group B, ≥3 tumors or tumor ≥3 cm in size at the time of intrahepatic recurrence and/or extrahepatic recurrence. Clinicopathological and survival data were analyzed retrospectively in each group to identify poor prognostic factors.


RESULTS
The 1-year recurrence rate was 50%, and the time to recurrence was shorter in group B (10 months) than in group A (20 months) Overall 1-, 3-, and 5-year survival rates were poorer in group B (83%, 52%, and 35% respectively; p < 0.001) than in group A (100%, 96%, and 71% respectively) Cancer spread (vascular invasion and/or intrahepatic metastasis) was significantly affecting the recurrence pattern of Group B (p=0.0238) on multivariate analysis.


CONCLUSIONS
Systemic adjuvant chemotherapy af ter curative hepatectomy for HCC in Child A should be given to patients with microscopic vascular invasion and/or intrahepatic metastasis.