2C). Recurrence rates at 1 and 5 years were 20% and 75%, respectively, for the cirrhosis subgroup. The overall rate of recurrence was significantly higher in the cirrhosis subgroup compared with the no cirrhosis subgroup (Table 2). The only variable associated

with survival on univariate analysis MAPK Inhibitor Library in the cirrhosis population was platelet count. Both a cutoff of 100,000/μL (P = 0.046) and a cutoff of 150,000/μL (P = 0.039) were significantly associated with survival (Table 5). The only variables significantly associated with time to recurrence on univariate analysis among these patients with cirrhosis were performing a nonanatomic resection (P = 0.017) and the presence of satellites (P = 0.035) (Table 5). Multivariate analysis was not conducted in this subgroup. Patients with no vascular invasion and no satellites (BCLC 0/Japanese selleck compound T1) on pathology were selected as “true” cases of very early HCC (n = 85). These patients had median and 5-year survivals of 138 months and 76% compared with 65.1 months and 57% (P = 0.137) for those with vascular invasion and/or satellites. Recurrence rates at 1 and

5 years were 12% and 61%, respectively, for this subgroup (Fig. 2D). Recurrence at 1 year was significantly lower for patients with very early tumors and the difference was just at the cutoff for significance for overall recurrence. The only variable significantly associated with survival on univariate analysis in this subgroup of patients was platelet count <150,000/μL (P = 0.011) and the only variable associated with recurrence was cirrhosis (stage Amino acid 4 fibrosis) (P = 0.012) (Table 5). Again, multivariate analyses were not performed. Performing an anatomic resection in these patients with no vascular invasion and no satellites did not result in lower early or overall recurrence. However, for the remaining 47 patients with either vascular invasion or satellites, performing an anatomic resection was associated with a significant reduction in recurrence at 1 year from

50% down to 11% (P = 0.008). Although there was a clear trend toward better overall survival as well as lower overall recurrence with anatomic resection in these 47 patients with either vascular invasion or satellites, the P values did not reach significance. There were 16 (12%) patients who were found to have satellites on pathology. The presence of satellites was not recognized preoperatively in any of the cases. As demonstrated in Tables 2 and 3, the presence of satellites was an independent predictor of survival, overall recurrence, and early recurrence at 1 year. By coincidence, half (n = of the patients with satellites underwent anatomic liver resections, whereas the other half did not. Despite the very small sample size, anatomic resection was associated with significantly better survival, lower overall recurrence, and lower early recurrence at 1 year in these patients (Figs. 2E,F).