Predictors of early recurrence of hepatocellular carcinoma after hepatic resection in a single Egyptian institute: A retrospective study.

Introduction: Liver resection for hepatocellular carcinoma (HCC) can have a recurrence rate of up to 50%. This studyaims to define potential factors that can have a role in recurrence of the tumor by defining very early recurrence (VER)in the first 6 months after surgery.Patients and Methods: This retrospective study was conducted on patients who underwent liver resection for HCC in thesurgery department at Tanta University over 6 years between 2016 and 2022.Collection of the preoperative, operative and postoperative data of 131 patients that met our criteria including laboratory, radiology and histopathology was done and postoperative complications, recurrence, and overall survival were reported.Analysis of the data available was done to figure out any correlation between these variants and both recurrence (including VER) and survival.Results: There was a significant relation between preoperative alpha-fetoprotein (AFP) and recurrence. Elevation of liverenzymes [alanine transaminase (AST), aspartate aminotransferase (ALT)] was an incident that was recorded after surgeryand there was a significant relation between the maximal elevation of AST, ALT, and recurrence. For VER maximumtumor diameter and preoperative AFP were significantly related to VER and also postoperative maximum AST had beenshown to have a significant relation with recurrence. Of 131 patients, 92 patients are still alive at the last date of followupand 39 patients are deceased. Age of the patients (mean 68.1±11 SD) and maximum tumor diameter were found besignificant factor in relation with mortality.Conclusion: Within multiple preoperative and operative risk factors beside the criteria of the tumor, our study definedmaximum tumor diameter, moderate to poor differentiation of the tumor, Milan criteria, preopertive AFP, postoperativeAST, ALT as significant risk factors for recurrence.