title: Results of repeated hepatectomy for recurrent hepatocellular carcinoma.
abstract: OBJECTIVE
  The long-term outcome of patients undergoing repeated hepatectomy for secondary hepatocellular carcinoma (HCC) were investigated to assess the selection criteria for, and efficacy of, repeated hepatectomy.
  
  
  METHODS
  21 patients with secondary HCC who had undergone repeated hepatectomy (R group) were analyzed. Clinical characteristics, histopathologic findings and postoperative clinical course were compared for patients with primary and secondary HCCs in the R group. The risk factors for post repeated hepatectomy survival and disease-free survival were estimated for the R group.
  
  
  RESULTS
  There were no significant differences in patient characteristics or histologic features of primary and secondary HCCs in the R group. A significant difference in cumulative postoperative disease-free survival was not seen for primary and secondary HCCs, average duration was 39.4 and 21.3 months. Liver cirrhosis and narrow hepatectomy (subsegmentectomy, limited resection and enucleation) were found to be significant risk factors of survival after secondary hepatectomy. The 5-year post-recurrence survival rate of nine patients in the R group who had two risk factors was 14.8%.
  
  
  CONCLUSIONS
  In cirrhotic patients with secondary HCC, inadequate narrow repeated hepatic resection should not receive repeated hepatectomy.
authors.affiliation: Department of Surgery, Division of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji-Kawaramachi Kamigyo-ku, Kyoto 602-8566, Japan. tochiai@koto.kpu-m.ac.jp
authors.forename: Toshiya
authors.initials: T
authors.lastname: Ochiai
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Sonoyama
authors.forename: Shojiro
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Hiroo
authors.initials: H
authors.lastname: Konishi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kitagawa
authors.forename: Tokunari
authors.initials: T
authors.lastname: Okayama
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ichikawa
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ueda
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
authors.forename: Hisakazu
authors.initials: H
authors.lastname: Yamagishi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D012307:Risk Factors; D015996:Survival Rate