title: Recurrent hepatocellular carcinoma after hepatic resection: prognostic factors and long-term outcome.
abstract: OBJECTIVE
  The prognosis of patients with recurrent hepatocellular carcinoma (HCC) after hepatic resection varies widely. This study analyzed long-term survival and prognostic factors of patients with recurrent HCC after hepatectomy.
  
  
  METHODS
  From July 1991 to December 2000, 623 patients underwent hepatic resection for HCC. Of those, 347 (56.5%) patients had tumour recurrence, and 286 patients with follow-up time more than 24 months after recurrence were enrolled. Twenty-seven clinicopathologic factors underwent both univariate and multivariate analysis.
  
  
  RESULTS
  Of these 286 patients, survival times after tumour recurrence were mean 672+/-619 days; median 468 days; and, range 10-3753 days. The overall 1-, 3-, 5-, and 10-year post-recurrence survival rates were 61.5, 33.4, 18.2, and 9.0%, respectively. Seventy (24.5%) patients were alive at the time of study, and 10 of the 34 patients who underwent re-resection were disease-free. By Cox regression analysis, multiple initial tumours (relative risk (RR) 1.428), recurrent multiple (RR 1.372), extrahepatic recurrence (RR 2.434), recurrent tumour size >2 cm (RR 1.926), post-hepatectomy period until recurrence <1 year (RR 1.769), and non-resectional treatment of recurrent tumours (RR 3.527) were independent prognostic factors for post-recurrent survival rates.
  
  
  CONCLUSIONS
  In patients with recurrent HCC after hepatectomy, both initial and recurrent tumour factors influenced their prognosis. Early detection of recurrent tumours is important. Re-resection correlated with better post-recurrent survival rates.
authors.affiliation: Department of Surgery, Taipei Veterans General Hospital, College of Medicine, National Yang-Ming University, Shih-pai, Taipei, Taiwan.
authors.forename: W-T
authors.initials: WT
authors.lastname: Chen
authors.forename: G-Y
authors.initials: GY
authors.lastname: Chau
authors.forename: W-Y
authors.initials: WY
authors.lastname: Lui
authors.forename: S-H
authors.initials: SH
authors.lastname: Tsay
authors.forename: K-L
authors.initials: KL
authors.lastname: King
authors.forename: C-C
authors.initials: CC
authors.lastname: Loong
authors.forename: C-W
authors.initials: CW
authors.lastname: Wu
mesh_terms: D000368:Aged; D000782:Aneuploidy; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality*; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome