Application and Outcomes of Repeat Hepatectomy for Recurrent Hepatocellular Carcinom

Cho, Yong Suk; Kim, Ki Doong; Kim, In Hoo; Lee, Dong Shik; Yoon, Sung Su; Kim, Hong Jin; Kang, Su Hwan

Abstract

PURPOSE
The effective treatment of an intrahepatic recurrent hepatocellular carcinoma (HCC) after a curative resection is very important in improving the prognosis after resection of HCC. The purposes of this study were to evaluate the clinicopathological characteristics and clarify the outcome of the patients after a repeat hepatectomy for a recurrent HCC. METHODS: Between March 1991 and February 2004, 16 patients underwent repeat hepatectomy for a recurrent HCC at the Yeungnam university hospital. The clinicopathological and follow-up data were retrospectively analyzed. RESULTS: There was no significant difference in the average of ICG R15 between the primary (11.2+/-1.8%) and repeat hepatectomy (18.2+/-2.8%). There were a higher proportion of minor (Couinaud's segment < or =2) resection in the repeat (93.8%) than the primary hepatectomy groups (75.0%), but the difference was not statistically significant. A significant difference was seen in the tumor size between the primary (3.6+/-0.5 cm) and repeat hepatectomy groups (2.9+/-1.9 cm). The average number of tumor in both the primary and repeat hepatectomy was equal (1.3+/-0.6). The number of cases of multicentric occurrence of HCC (12 cases) was more than that of intrahepatic metastasis of HCC (4 cases). The mean interval between the primary and repeat hepatectomy was 48.0+/-33.0 months (13~136 months). The average survival time after a primary hepatectomy was 83.6+/-36.3 months. The cumulative 1, 3, 5, and 7 year survival rates were 100, 100, 85.9, and 75.3% after a primary hepatectomy and 90, 56.5, 56.5 and 56.5% after a repeat hepatectomy, respectively. CONCLUSION: A repeat hepatectomy leads to a satisfactory outcomes in selected HCC patients.