All discrepancies in scoring were reviewed, and a consensus was reached. The follow-up ended on May 2009; the median follow-up duration was 18.2 months (range, 3.3-61.5 months). Patients were checked every 2-3 months during the first 2 years and every 3-6 months thereafter. All follow-up examinations were performed by physicians who were unaware of the study. During each checkup, patients were monitored for tumor recurrence by assaying serum AFP levels and performing abdominal ultrasound examinations. A computed tomography and/or magnetic resonance imaging examination was performed every 3-6 months together with chest radiographic Deforolimus examination. The diagnostic criteria for HCC recurrence

were the same as for preoperative criteria. Once the recurrence was confirmed, patients were further treated on the basis of size, number, and location of recurrent tumors, as well as liver function.

Repeated liver resection was recommended for patients with a solitary liver recurrence and Child-Pugh class A liver disease, without distant metastasis and portal hypertension. Patients with multiple intrahepatic recurrence or compromised hepatic function selleck chemicals were treated with radiofrequency ablation, percutaneous ethanol injection, and/or percutaneous transcatheter arterial chemoembolization. External radiotherapy was administered if lymph node or bone metastasis was confirmed. In this series, three patients were lost to follow-up, eight patients died of recurrence-free liver failure, and one died of stroke. Time to recurrence (TTR) and overall survival were considered the primary endpoints. TTR was calculated from the date of resection to the date when tumor recurrence was diagnosed; overall survival was calculated from the date of resection to the date of death HSP90 or last follow-up.28 All statistical analyses were performed with SPSS version 10.0 software. The χ2 test or Fisher’s exact test were used to compare qualitative variables, while continuous variables were compared using

Student t test or Mann-Whitney test for variables with an abnormal distribution. Receiver operating characteristic curve analysis was used to determine the optimal cutoffs of continuous variables. Survival curves were calculated using the Kaplan-Meier method and compared using a log-rank test. The Cox proportional hazards model was used to determine the independent factors on survival and recurrence, based on the variables selected on univariate analysis. P < 0.05 was considered statistically significant. To compare gene expression profiling between HCC and normal liver tissues, we performed cDNA microarray hybridization and found that 1,052 out of 5,760 functional genes were differentially expressed (Supporting Fig. 1). Among all the up-regulated genes, AAH mRNA expression was most remarkably elevated (up to12.35-fold). The up-regulation of AAH mRNA was further confirmed in another 40 paired tumor and nontumorous samples by way of RT-PCR assay, in which 31 of 40 (77.