[Prognostic factors and outcome in patients with intrahepatic recurrence after hepatectomy for hepatocellular carcinoma].
OBJECTIVE
To investigate the prognostic factors and treatment choice for intrahepatic recurrence after hepatectomy in patients with hepatocellular carcinoma (HCC).


METHODS
Clinicopathological data of 184 HCC patients with intrahepatic recurrence after hepatectomy were collected. The influences of twenty one clinicopathological factors and treatment modalities on the survival after recurrence were retrospectively analyzed.


RESULTS
Univariate analysis showed that preoperative serum alpha-fetoprotein (AFP) >100 ng/ml, microscopic venous invasion, patients classified as Child-Pugh class B or C at diagnosis of recurrence, multiple recurrence foci and early recurrence (< or =12 months) were poor prognostic factors. Cox multivariate analysis showed that Child-Pugh class at diagnosis of recurrence, number of recurrent foci and time to recurrence were independent risk factors for survival in patients with recurrence. Median survival after recurrence was 34 months, 23 months, 15 months and 9 months, respectively, in patients treated by repeated hepatectomy, local ablation therapy, transcatheter arterial chemoembolization (TACE) or non-treatment in 69 patients with solitary recurrence. There were statistically significant differences among these four groups (P < 0.05).


CONCLUSIONS
classification of Child-Pugh class A at the first time of diagnosis, solitary recurrence, late recurrence (> 12 months), and intrahepatic recurrence occurred after repeated hepatectomy or local ablation therapy are better prognostic factors in patients with HCC recurrence.
Yang
Li-tao
LT
Department of Abdominal Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China. surylt@hotmail.com
Cheng
Xiang-dong
XD
Du
Yi-an
YA
Wang
Xin-bao
XB
Zhang
Yun-li
YL
Guo
Jian-min
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000378:metabolism / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000378:metabolism / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000378:metabolism
D000509:alpha-Fetoproteins