Sasaki Y et al. (2006) Risk of recurrence in a long-term follow-up after surgery in 417 patients with hepatitis B- or hepatitis C-related hepatocellular carcinoma. Ann Surg 244: 771–780

Patients with hepatitis-C-related hepatocellular carcinoma (HC-HCC) have a higher risk of recurrence after surgery than those with hepatitis-B-related hepatocellular carcinoma (HB-HCC), according to researchers in Japan. Sasaki et al. conducted a long-term follow-up of patients who underwent surgery for HB-HCC (n = 66) or HC-HCC (n = 351) between January 1990 and December 1999.

The median follow-up was 11.0 years for patients with HB-HCC and 10.1 years for those with HC-HCC. Recurrence occurred in 39 (59%) patients with HB-HCC and 282 (80%) with HC-HCC. The odds ratio for risk of recurrence for HC-HCC compared with HB-HCC was 1.93. The 3-year, 5-year and 10-year disease-free survival rates were 57%, 54% and 28%, respectively in the HB-HCC group and 40%, 24% and 12%, respectively in the HC-HCC group.

Although the recurrence rates were similar for the two viral groups during the first 2 years of follow-up, the long-term prognosis was considerably worse in patients with HC-HCC, probably because of a higher frequency of metachronous carcinogenesis in these patients. The authors believe that HCC recurrence in both groups was probably caused by intrahepatic metastasis during the first 2 years. They conclude that the type of viral infection must be taken into account when devising treatment strategies for hepatitis-infected patients with HCC.