SURGICAL TREATMENT OF RECURRENT HEPATOCELLULAR CARCINOMA AFTER HEPATIC RESECTION IN TERMS OF MODES OF RECURRENCE AND LONG-TERM RESULTS OF RE-RESECTED CASES

Abstract

This study deals with the indication and significance of surgical therapy for recurred hepatocellular carcinoma in terms of comparison of prognoses by modes of recurrence and long-term therapeutic results after re-hepatectomy. Subjects were 79 recurred cases after hepatectomy. For comparison, the survival rates after recurrence were calculated by the following five items; time from operation to recurrence, the existence of extrahepatic growth, mode of recurrence in the remnant liver, recurred site in the remnant liver, and therapy after recurrence. As a result, significantly better prognoses were noted in recurrences after 2 years of time lapse following hepatectomy, no extrahepatic growth, solitary cases, and re-resected cases. No significant difference was observed between the sites of recurrence in the remnant liver, namely isolateral and counterlateral lobes. In 11 re-resected cases which involved only three cases suspected of heterochronous multicentric carcinoma, a mean survival time after re-resection of solitary recurrence in the remnant liver was as good as 5.2 years. And five patients of them have not experienced re-recurrence for 5 years after the re-resection. It is thought that re-resection can be considered aggressively in patients with two factors, namely, recurrence after 2 years following hepatectomy and solitary recurrence in the hepatic remnant. And the re-resection which provides favorable prognosis appears to be significant for such cases.