Abstract
BackgroundThis study aimed to assess the efficacy and safety of repeat hepatectomy for recurrent hepatocellular carcinoma (HCC).MethodsThirty-seven patients who underwent a curative repeat hepatectomy in our hospital were retrospectively studied. An extensive database literature search was performed to obtain for all relevant studies.ResultsIn our series, there were no perioperative deaths during repeat hepatectomy for recurrent HCC. Patients survival after repeat hepatectomy were similar to 429 patients undergoing initial hepatectomy. A computerized search of the Medline and PubMed databases found 29 retrospective studies providing relevant data in 1149 patients were included for appraisal and data extraction. After the repeat hepatectomy, postoperative morbidity ranged from 6.2% to 68.2% with a median per cohort of 23.5 per cent. There were 7 perioperative deaths (0.7 per cent of 993 for whom mortality data were provided). The overall median survival ranged from 21 to 61.5 months, with 1 -, 3 -, and 5-year survival of 69.0% to 100%, 21.0% to 87.0%, and 25.0% to 87.0%, respectively.ConclusionsRepeat hepatectomy can be performed safely and is associated with long-term survival in a subset of patients with recurrent HCC. However, the findings have to be carefully interpreted due to the lower level of evidence. A randomized controlled study is needed to compare repeat hepatectomy and other modalities for recurrent HCC.
Highlights
This study aimed to assess the efficacy and safety of repeat hepatectomy for recurrent hepatocellular carcinoma (HCC)
The role of Transcatheter arterial chemoembolization (TACE) therapy in the treatment of postoperative recurrence is pessimistic, with 5-year survival rates only range from 0% to 27%, even with repeated TACE treatment [3,4,5]
Many treatment centers advocate the repeat hepatectomy is the first choice of treatment for recurrent HCC and have claimed that it is safe and that it has similar survival results to initial hepatectomy [6]
Summary
This study aimed to assess the efficacy and safety of repeat hepatectomy for recurrent hepatocellular carcinoma (HCC). The long-term survival after hepatectomy remains unsatisfactory because of the high incidence of recurrence. Hepatic resection is the only therapy that is potentially curative for liver tumors, and offers patients a chance of long-term survival. Many treatment centers advocate the repeat hepatectomy is the first choice of treatment for recurrent HCC and have claimed that it is safe and that it has similar survival results to initial hepatectomy [6]. Due to the limited numbers of patients who undergo resection at a single institute, a thorough assessment of the outcome of repeat hepatectomy for recurrent HCC has not been reported.
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