Postoperative recurrence of solitary small hepatocellular carcinoma.
The prognosis of hepatocellular carcinoma after hepatic resection remains poor. The major cause is postoperative recurrence, most frequently intrahepatic. During the past 7 years, we conducted a detailed study of recurrence after hepatectomy in 34 patients with solitary small hepatocellular carcinoma measuring no larger than 4 cm in diameter, in which 13 cases had postoperative recurrent tumors, and two cases were considered multicentric. Eighty-five percent of recurrences were diagnosed at 6-18 months after the operation. The cumulative recurrence rates were 61% at 5 years after operation. When analyzing the factors affecting recurrence, a significant difference was observed regarding tumor diameter. After recurrence, most patients underwent percutaneous ethanol injection treatment and/or transcatheter arterial chemoembolization and lipiodolization. Four patients died of progressive disease within 1 year after recurrence; the treatment thus seemed to have no effect. The other patients with recurrence remain alive with the disease. The overall cumulative survival rates in this series were 76% at 3 years and 60% at 5 years after operation. To obtain better results after hepatectomy, even for small hepatocellular carcinoma, careful, long-term follow-up evaluation is therefore necessary for the multidisciplinary treatment of the postoperative recurrence, as well as the early diagnosis of tumors in high-risk patients.
Ezaki
T
T
Department of Surgery, lizuka Hospital, Fukuoka, Japan.
Koyanagi
N
N
Yamagata
M
M
Kajiyama
K
K
Maeda
T
T
Sugimachi
K
K
D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods; D018450:Disease Progression; D000431:Ethanol / Q000008:administration & dosage; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007261:Infusions, Intra-Arterial; D007459:Iodized Oil / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012307:Risk Factors
D000431:Ethanol; D007459:Iodized Oil