title: Postoperative recurrence of hepatocellular carcinoma. Two hundred five consecutive patients who underwent hepatic resection in 15 years.
abstract: OBJECTIVE
  To report the results of our investigation of the postoperative intrahepatic recurrent rates and the patterns of recurrence and to determine the factors that influenced these patterns of recurrence.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Department of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.
  
  
  METHODS
  Between 1977 and 1991, 162 men and 43 women with hepatocellular carcinoma underwent hepatic resection.
  
  
  RESULTS
  The surgical mortality rate was 4.4%. Of the 196 patients who were discharged from the hospital, 114 have since died and 20 were not available for follow-up. The overall cumulative recurrent rates for the last 5 years (1987 through 1991) were 59.7%, 65.0%, 76.5%, 77.0%, and 79.7%, respectively. Eighty patients experienced intrahepatic recurrence. Of these, 21 (26.2%) had recurrence near the resected stump, 43 (53.8%) had a single nodular recurrence in the remnant liver, and 16 (20%) had wide-spread multinodular recurrence. The patients with resected margins of less than 1 cm in diameter had relatively higher recurrence rates than those with resected margins of greater than 1 cm in diameter. All recurrences were noted within 3 years of the resection. The preoperative serum alpha-fetoprotein levels were directly related to the length of time to recurrence (ie, the higher the serum alpha-fetoprotein level, the sooner the recurrence).
  
  
  CONCLUSIONS
  The postoperative intrahepatic remnant rate is very high; 80% by 5 years after resection. The preoperative serum alpha-fetoprotein level and adequacy of the cut margin significantly influenced the recurrence rate.
authors.affiliation: Department of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.
authors.forename: M F
authors.initials: MF
authors.lastname: Chen
authors.forename: T L
authors.initials: TL
authors.lastname: Hwang
authors.forename: L B
authors.initials: LB
authors.lastname: Jeng
authors.forename: C S
authors.initials: CS
authors.lastname: Wang
authors.forename: Y Y
authors.initials: YY
authors.lastname: Jan
authors.forename: S C
authors.initials: SC
authors.lastname: Chen
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods / Q000401:mortality; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D012086:Reoperation; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000509:alpha-Fetoproteins