title: Repeated hepatic resection for recurrent hepatocellular carcinoma in eighteen cases.
abstract: BACKGROUND
  Although intrahepatic recurrence after hepatic resection for hepatocellular carcinoma is the most significant cause of death, very few reports are available for hepatic re-resection as a radical treatment for recurrence.
  
  
  METHODS
  Eighteen patients who underwent repeated hepatic resections for hepatocellular carcinoma were evaluated. Most of the patients regularly received measurement of alpha-fetoprotein level once a month and examination by ultrasonography and/or computed tomography scanning once every 3 to 4 months.
  
  
  RESULTS
  No operative deaths occurred. The alpha-fetoprotein levels of 9 of the 18 patients were within the normal range. Most patients underwent limited hepatic resection to maintain the remaining hepatic function. The 1-, 3-, and 5-year cumulative survival rates after repeated resection were 88%, 37%, and 37%, respectively. The 3-, 5-, and 7-year survival rates after the first resection were 88%, 68%, and 45%, respectively. These showed no significant difference from the survival rates of patients with no recurrences after hepatic resection.
  
  
  CONCLUSIONS
  Careful follow-up examinations after hepatic resection are needed for early detection of recurrences, and efforts should be made for repeated hepatic resection, which leads to satisfactory outcome.
authors.affiliation: Surgical Service, Nagoya Memorial Hospital, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Suenaga
authors.forename: H
authors.initials: H
authors.lastname: Sugiura
authors.forename: Y
authors.initials: Y
authors.lastname: Kokuba
authors.forename: S
authors.initials: S
authors.lastname: Uehara
authors.forename: T
authors.initials: T
authors.lastname: Kurumiya
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications / Q000401:mortality; D012086:Reoperation; D016019:Survival Analysis; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000509:alpha-Fetoproteins