title: Efficacy of laparoscopic surgery for recurrent hepatocellular carcinoma.
abstract: OBJECTIVE
  Although laparoscopic hepatectomy is increasingly performed for hepatocellular carcinoma, few studies have investigated the efficacy of laparoscopic surgery, including hepatectomy for the treatment of recurrent hepatocellular carcinoma. We report the results of our study on the efficacy of laparoscopic surgery.
  
  
  METHODS
  Forty-three of 123 hepatocellular carcinoma patients underwent laparoscopic surgery in 2002-2009; 16 were treated for recurrent hepatocellular carcinoma. The characteristics and postoperative outcomes of these 16 patients were retrospectively investigated.
  
  
  RESULTS
  Seven patients underwent laparoscopic hepatectomy, 1 underwent laparoscopic radiofrequency ablation, 7 underwent resection of an extrahepatic metastatic tumor and 1 patient received diagnostic assessment. Twelve of the 15 surgical patients had a repeat recurrence after surgery. Survival at 2 years was significantly higher in patients with intrahepatic vs. extrahepatic recurrence (100% vs. 42.9%). In addition, overall survival (51.2 vs. 23.0 months) was significantly longer in patients with intrahepatic recurrence, although disease-free survival (19.2 vs. 10.6 months) was not so.
  
  
  CONCLUSIONS
  Laparoscopic surgery for recurrent hepatocellular carcinoma enabled precise tumor localization, more accurate diagnosis, and more careful selection of therapy based on hepatic functional reserve and recurrence type. Laparoscopic surgery appears to be an effective, minimally invasive option for the diagnosis and treatment of recurrent hepatocellular carcinoma.
authors.affiliation: Department of Surgery, Toho University School of Medicine, Tokyo, Japan. tucchie@nifty.com
authors.forename: Masaru
authors.initials: M
authors.lastname: Tsuchiya
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Otsuka
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Maeda
authors.forename: Jun
authors.initials: J
authors.lastname: Ishii
authors.forename: Akira
authors.initials: A
authors.lastname: Tamura
authors.forename: Hironori
authors.initials: H
authors.lastname: Kaneko
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D006528:Carcinoma, Hepatocellular / Q000556:secondary / Q000601:surgery*; D017115:Catheter Ablation; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy; D007902:Length of Stay; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors