Aggressive management of recurrence following surgical resection of hepatocellular carcinoma.
BACKGROUND
Liver resection of hepatocellular carcinoma (HCC) is associated with a high incidence of recurrence, that has a poor prognosis.


OBJECTIVE
Assess the rationale for and result of an aggressive treatment of recurrence following resection of HCC.


METHODS
Retrospective analysis of 132 patients with recurrent HCC with special reference to the topography and time of onset of recurrence as well as outcome following treatment of these recurrences. Case-control analysis of the efficacy of repeat hepatectomy and its influence on the long term prognosis of patients with recurrent tumor.


RESULTS
Sixty seven percent of the recurrences were exclusively intrahepatic and half of these were limited in size and number. The 5-year survival rate following treatment of limited intrahepatic recurrence by repeat hepatectomy, arterial chemoembolization or percutaneous ethanol injection was 30%. Repeat hepatectomies improved the long term outcome of patients with recurrent HCC.


CONCLUSIONS
An aggressive approach to tumor recurrence is currently the best way to improve the long term outcome following resection of HCC.
Farges
O
O
Department of Hepato-biliary and Digestive Surgery, Beaujon Hospital, University Paris VII, Clichy, France.
Regimbeau
J M
JM
Belghiti
J
J
D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D016022:Case-Control Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D016019:Survival Analysis