Background : Early recurrence after surgical resection for hepatocellular carcinoma (HCC) significantly impacts patient survival rates. This study aimed to identify factors contributing to early recurrence following hepatic resection for HCC.

Methods : A retrospective study was conducted, involving 519 patients who underwent hepatic resection for HCC at CNUHH between 2012 and 2020. Patients were categorized based on the timing of recurrence: those experiencing recurrence within two years and those with recurrence after two years. Further sub-analysis compared patients with recurrence within one year to those with recurrence between one and two years post-surgery.

Results : The 433 analyzed recurrent patients included 147 who experienced early recurrence, while 44 had late recurrence. Within the early recurrence group, 94 patients relapsed within one year. Multivariate analysis identified tumor size > 5 cm and vascular invasion as closely associated with early recurrence following liver resection for HCC. In the sub-analysis comparing patients with recurrence within one year to those between one and two years, significant values were observed for AST, ALT, and ALP levels of preoperative laboratory values in multivariate analysis.

Conclusions : Tumor size and vascular invasion were associated with early recurrence, while pre-operative liver enzyme levels were related to recurrences within one year. These findings suggest that when treating HCC, consideration should be given to more extensive or anatomical resections based on tumor factors to reduce early recurrence. Additionally, elevated pre-operative liver enzyme levels may warrant additional preoperative assessments, which can inform the choice of an appropriate treatment approach.