To investigate the value of preoperative serum carbohydrate antigen (CA)19-9 in predicting the recurrence of hepatitis B virus (HBV) related hepatocellular carcinoma (HCC) after R0 resection.

Clinical data of 544 patients with HBV related HCC undergoing R0 resection in the Affiliated Hospital of Qingdao University Medical College from January 2002 to December 2012 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. There were 470 males and 84 females, aged from 17 to 82 years old with a median age of 55 years old. According to the follow-up results, the receiver operating characteristic (ROC) curve of preoperative serum CA19-9 predicting the postoperative recurrence of HCC was drawn and the cut-off point of CA19-9 was determined. The patients were divided into the CA19-9 increasing group and CA19-9 normal group according to the cut-off point of CA19-9. The survival rates of two groups were compared by Z test.

The cut-off point of CA19-9 predicting the postoperative recurrence of HCC was 22.2 kU/L, by which 258 cases were assigned in the CA19-9 increasing group and 296 cases in the CA19-9 normal group. The median disease free survival (DFS) time in the CA19-9 increasing group and CA19-9 normal group was respectively 30.0 and 49.5 months, and the 1-, 2-, 3-, 4-, 5-, and 10-year DFS rates were respectively 78.1%, 57.0%, 46.8%, 44.6%, 33.2%, 16.9% and 74.7%, 61.1%, 55.3%, 54.4%, 46.8%, 38.7% , and significant differences were observed between two groups in the 4-, 5- and 10-year DFS rates(Z=5.315, 7.107, 11.444; P<0.05).

Preoperative serum CA19-9 is an index for predicting the long-term recurrence of HBV related HCC after R0 resection.