Prediction for Postoperative Intrahepatic Recurrence of Hepatocellular Carcinoma

Abstract

Hepatic resection is the most effective therapy for hepatocellular carcinoma (HCC); however, intrahepatic recurrence is common. In this preliminary study, we examined whether intraoperative indocyanine green (ICG) fluorescence liver imaging is associated with HCC recurrence after curative resection. A total of 32 patients with HCC underwent primary curative hepatectomy. ICG was injected intravenously before surgery as a routine preoperative liver function test. A near-infrared fluorescence imaging system was used to obtain the ICG fluorescence imaging. The patients were divided into two groups according to the intraoperative ICG fluorescence imaging pattern: scattered pattern (SP Group, n = 17) and non-scattered pattern (non-SP Group, n = 15). The 2-year recurrence-free survival (RFS) rates of the SP Group and non-SP Group were 41.2 % and 86.7 %, respectively (P = 0.008). Preoperative α-fetoprotein level, microscopic portal vein invasion, and ICG fluorescence pattern correlated with RFS on univariate and multivariate analysis. Intraoperative ICG fluorescence liver imaging predicts early intrahepatic recurrence after curative hepatic resection for HCC.