title: Prognostic impact of treatment modalities on patients with single nodular recurrence of hepatocellular carcinoma.
abstract: OBJECTIVE
  To evaluate the prognostic impact of various therapeutic modalities, such as repeat hepatectomy, ablation therapy, and transcatheter arterial chemoembolization (TACE) therapy, used to treat single nodular recurrent hepatocellular carcinoma (HCC).
  
  
  METHODS
  Thirty-two patients with single nodular intrahepatic recurrence after curative primary resection of HCC were enrolled in this study. The prognostic factors after recurrence were established using 13 clinicopathologic variables, including the therapeutic modalities; namely, repeat hepatectomy, ablation therapy, or TACE therapy.
  
  
  RESULTS
  Of the 32 patients, 9 underwent repeat hepatectomy, 10 underwent ablation therapy, and 13 underwent TACE therapy. The therapeutic modality was the only prognostic factor. In comparison with TACE therapy, the relative risks associated with ablation therapy and repeat hepatectomy were 0.19 and 0.29, respectively. The 5-year survival rates after single nodular recurrence were 57% in the ablation therapy group, 29% in the repeat hepatectomy group, and 0% in the TACE therapy group.
  
  
  CONCLUSIONS
  Repeat hepatectomy and ablation therapy are more effective than TACE therapy for improving the prognosis of patients with single nodular intrahepatic recurrent HCC.
authors.affiliation: Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Ueno
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Uchiyama
authors.forename: Satoru
authors.initials: S
authors.lastname: Ozawa
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nakase
authors.forename: Naoki
authors.initials: N
authors.lastname: Togo
authors.forename: Shinya
authors.initials: S
authors.lastname: Hayami
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamaue
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000628:therapy*; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic; D016009:Chi-Square Distribution; D005260:Female; D006498:Hepatectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D016016:Proportional Hazards Models; D012086:Reoperation / Q000401:mortality; D015996:Survival Rate