Virologic and Biochemical Changes and Prognosis after Liver Resection for Hepatitis B Virus-Related Hepatocellular Carcinoma

March 23, 2001

Virologic and Biochemical Changes and Prognosis after Liver Resection for

Hepatitis B Virus-Related Hepatocellular Carcinoma

Shoji Kuboa, Kazuhiro Hirohashia, Hiromu Tanakaa, Tadashi Tsukamotoa, Taichi

Shutoa, Ikko Higakia, Shigekazu Takemuraa, Takatsugu Yamamotoa, Shuhei

Nishiguchib, Hiroaki Kinoshitaa

aSecond Department of Surgery and bThird Department of Internal Medicine,

Osaka City University Medical School, Osaka, Japan

Digestive Surgery 18:1:2001, 26-33.

Abstract

Background/Aims: During the natural course of hepatitis B virus (HBV)

infection, clearance of HB e antigen (HBeAg) and HB surface antigen (HBsAg)

occurs with remission of liver disease. We investigated the effects of

postoperative changes in virologic and biochemical parameters on the

prognosis after liver resection for HBV-related hepatocellular carcinoma

(HCC). Methods: We investigated the relationship between postoperative

changes in virologic and biochemical parameters and the incidence of

intrahepatic recurrence and the outcome during a 3-year period following

surgery in 30 HCC patients with HBsAg. Results: The incidence of

intrahepatic recurrence of HCC was significantly higher in patients with

acute postoperative exacerbation of hepatitis (p = 0.0084), a sustained high

serum concentration of HBV DNA (5.0 mEq/ml, p = 0.001), and sustained

expression of HBsAg after surgery (p = 0.0421). A high serum concentration

of HBV DNA was significantly associated with a shorter survival time (p =

0.0447) and the cause of death was recurrence of HCC. Conclusion: Patients

with acute postoperative exacerbation of hepatitis, sustained HBsAg

expression, and sustained high serum concentrations of HBV DNA after surgery

may require more intensive postoperative monitoring for HCC recurrence.

Vol. 18, No. 1, 2001

Digestive Surgery

March 23, 2001