Influence of alcohol abuse on recurrence after curative resection of hepatocellular carcinoma

We studied the influence of alcohol abuse (ethanol intake > 80 gm/day for > 5 yr.) on recurrence in 81 patients with hepatocellular carcinoma who had undergone curative hepatic resection. Twenty-nine patients were positive for alcohol abuse [AA(+)] and 52 were not [AA(-)].

Recurrence of carcinoma within 2 and 27 postoperative months was observed in 45 (55.6%) of the 81 patients. The median disease-recurrence time was 12.0 mo in the AA(+) group and 24.1 mo in the AA(-) group (p<0.01). The patterns of recurrence were classified into the following 4 types: single-nodular type (intrahepatic single nodule); multi-nodular type (intrahepatic multiple nodules); whole liver type (diffuse recurrence over the whole remnant liver); and extrahepatic type (extrahepatic recurrence alone). Five (29.4%) of the 17 patients with recurrence in the AA(+) group demonstrated the whole liver type, compared with only 2(7.1%) of the 28 patients in the AA(-) group (p<0.05).

Patients with alcohol abuse should be followed up particularly closely, even if they have received curative surgery, since alcohol abuse is strongly related to postoperative recurrence.