Results of repeated hepatectomy for recurrent hepatocellular carcinoma.
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.
Ochiai
Toshiya
T
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
Sonoyama
Teruhisa
T
Kikuchi
Shojiro
S
Konishi
Hiroo
H
Kitagawa
Masahiro
M
Okayama
Tokunari
T
Ichikawa
Daisuke
D
Ueda
Yuji
Y
Otsuji
Eigo
E
Yamagishi
Hisakazu
H
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