Background: Hepatocellular carcinoma (HCC) is a hypervascular tumor, and angiogenesis is important for tumor growth. Ephrin receptors are related with vascular system development and the polymorphism of EphB1 in the carcinogenesis of digestive tract has been reported. Our aim was to examine the polymorphsims of EphB 1 with the occurrence of Hepatocelluar carcinoma in Korean population. Methods: Genomic DNA was extracted from 182 patients with hepatocellular carcinoma (HCC), 266 healthy subjects. EphB 1 polymorphism was determined by polymerase-chain reaction-based assays, and the association with HCC was investigated. Results: With regard to EphB 1 polymorphism, A/A genotype at rs11926992, T/T genotype at rs7644369, A/A genotype at rs6776570, T/T genotype at rs3821502 and G/G genotype at rs6766459 were significantly associated with HCC but these were not associated with clinical characteristics of HCC. Conclusions: Five out of seven polymorphisms on Ephb1 gene were statistically associated with HCC, in the Korean population. Therefore, more studies of Ephb1 gene polymorphisms including various risk factors should be performed to use as genetic markers of HCC occurrence. Background: We aimed to compare the results of hepatectomy for HCC in patients older than 70 years old with those for younger patients. Methods: Clinicopathological data and outcomes for 155 elderly patients and 333 younger patients with HCC who underwent hepatectomy between 1992 and 2007 were retrospectively compared. Results: Although postoperative delirium was more common in the elderly group, there were no significant differences between the 2 groups with regard to operative morbidity, hospital death, disease-free survival, and overall survival. The overall recurrence rate was significantly higher in the elderly patients with alcohol abuse than in younger patients with alcohol abuse. Multivariate analysis revealed that preoperative alcohol abuse was a prognostic factor for elderly patients. Conclusions: Elderly patients with preoperative alcohol abuse should be followed closely, even after R0 surgery, because alcohol abuse is strongly correlated with postoperative recurrence and worse survival. Background: Little is known about the effect of transfusing fresh frozen plasma on the outcome after hepatectomy for hepatocellular carcinoma. Methods: Among 410 patients who underwent curative resection between 1992 and 2005, 180 patients had perioperative transfusion with whole blood or packed red blood cells and fresh frozen plasma (group A), while 46 patients were only transfused with packed red cells (group B), 43 patients were only transfused with fresh frozen plasma (group C), and 141 patients had no transfusion (group D). Results: Group C had significantly fewer postoperative complications and a shorter hospital stay than group A. Preoperative coagulation was significantly worse in group C. Survival was significantly better in groups C and D than in group A. Conclusions: Perioperative transfusion of fresh frozen plasma improves clotting factors without an adverse influence on the survival of patients with liver dysfunction undergoing resection of hepatocellular carcinoma. Background: This study investigated risk factors for postoperative liver failure after resection of hepatocellular carcinoma to detect markers that could identify candidates for hepatectomy. Methods: Perioperative risk factors for liver failure after hepatectomy were analyzed in 191 patients with hepatocellular carcinoma. Results: Liver failure occurred postoperatively in 16 patients, 3 of whom died. The hyaluronate/GSA-Rmax ratio was a risk factor for postoperative liver failure by univariate analysis and was the only risk factor according to multivariate analysis. All 3 patients who died had a hyaluronic acid/GSA-Rmax ratio 500 mg min/dl. Conclusions: To reduce postoperative liver failure, preoperative planning should employ various measures of the hepatic functional reserve, including tests of both parenchymal and nonparenchymal liver function. The hyaluronate/GSA-Rmax ratio can predict liver failure after hepatectomy, and a ratio greater than 500 mg min/dl is a relative contraindication to liver resection. The patient was a 73-year old Japanese man with chronic hepatitis C(CH-C) who achieved a sustained virological response(SVR) to interferon(IFN) therapy. As a result the liver functions were normalized and the histological findings of the liver also improved. However, 13 years after SVR, mild liver dysfunction was noticed along with a marked increase of tumor markers. Several modalities revealed huge liver tumors about 13 cm in greatest diameter in the left lobe invading the bile ducts and another tumor about 3 cm diameter in segment V. We performed liver biopsy and confirmed that this tumor was well-differentiated hepatocellular carcinoma (HCC). Only mild fibrosis development could be observed in the adjacent non-cancerous lesions. We successfully treated these tumors with transcatheter arterial chemoembolization and stereotactic radiosurgery. Recent studies revealed that the risk of developing HCC still exists even after SVR. Since most of HCC that develop in patients with SVR are usually detected within 5 years, several investigators speculate that HCC is already present but too small to be detected at the time of completion of IFN therapy. This speculation is not the case in our patient, since SVR was achieved 13 years ago and no HCV-RNA could be detected when HCC appeared. Therefore, another possible mechanism should be considered. An annual follow-up with strict surveillance program for HCC should be performed for more than 10 years after the completion of IFN therapy. Background/Aims: In order to investigate the role and importance of oxidative stress as to carcinogenecity of hepatocellular carcinoma (HCC) we analyze the expression of 8-Hydroxydeoxyguanosine (8-OHdG) in the liver tissue of the HCC patients with and without hepatitis viral marker. Methods: Patients undergoing hepatic resection for the first HCC from 1995 to 2004 were enrolled into the study. Only the cases that took no alcohol or small amount of alcohol were enrolled. 24 cases were negative for hepatitis B surface antigen (HBsAg) and antibody to hepatitis C virus (HCVAb) (NBNC group). 24 were positive for HBsAg and negative for HCVAb (B group). 21 were positive for HCVAb and negative for HBsAg and antibody to hepatitis B core antigen (C group). Staining with hematoxylin and eosin (H&E) and Berlin-Blue, and immunohistochemical staining for 8-OHdG were performed using the non cancerous liver regions. The degree of 8-OHdG immunostaining was expressed as the labeling index, which means the percentage of positive hepatocytes per 1000 hepatocytes. Results: The labeling index of 8-OHdG for NBNC group is 19.3(±55.3), significantly lower (p=0.014) than that for B group 49.7(±89.5), and also lower (p=0.016) than that for viral group (B group and C group)(35.4±71.8).