Tissue factor is a useful prognostic factor of recurrence in hepatocellular carcinoma in 5-year survivors.

Background/Aims: Tissue factor (TF) is a transmembrane glycoprotein involved in initiating blood coagulation. TF has recently been reported to play an important role in tumor metastasis. The aim of this study was to evaluate the role and the prognostic value of TF in hepatocellular carcinoma (HCC) in long-term survivors. Methodology: Among 275 patients who underwent curative hepatectomy for HCC, 62 patients who survived more than 5 years after surgery were retrospectively studied. TF expression was immunohisto-chemically examined. Results: TF was positive in 39 of the 62 patients. In patients with TF expression, the serum albumin level was significantly lower and capsular infiltration, tumor thrombus in the portal vein, and intrahepatic metastasis were more frequently shown than those without TF expression. The recurrence-free rate was significantly higher in the patients whose tissue stained negative for TF than in those whose tissue stained positive for TF. Multivariate analysis showed TF expression to be a significant and independent risk factor for recurrence. Concerning the recurrence pattern, all 23 patients with intrahepatic metastasis were TF-positive, whereas 3 out of 5 patients with multicentric carcinogenesis were TF-positive. Conclusions: TF expression is closely associated with the tumor invasion and metastasis, and may serve as a useful prognostic factor of recurrence in HCC in 5-year survivors.