期刊
JOURNAL OF HEPATOLOGY
卷 55, 期 2, 页码 346-350出版社
ELSEVIER
DOI: 10.1016/j.jhep.2010.11.026
关键词
Hepatocellular carcinoma; Resection; Hepatectomy; Recurrence; Recurrent; Second; Repeat
资金
- National Institute of Health [K24 DK 60498-01]
Background & Aims: Recurrence of hepatocellular cancer after resection is a significant problem. The optimal treatment of patients with intrahepatic recurrence after resection and well-preserved liver function is not clear. We analyzed the outcomes of patients undergoing a second hepatic resection for recurrent hepatocellular cancer at a single Western center. Methods: The records of all patients undergoing primary hepatic resection for hepatocellular cancer between January 1994 and January 2009 were reviewed. Patients with a single intrahepatic recurrence, Child's A liver function, and platelet count > 100,000/mu l underwent a second hepatic resection. Clinical data was recorded and analyzed. Results: Of the 487 patients undergoing primary resection, 221 developed recurrence, and 35 underwent a second hepatic resection. There were no perioperative mortalities. There were 10 deaths during the study period; 5-year overall survival was 67% from second resection. Time to recurrence from primary resection <1 year and gross vascular invasion at second resection were predictors of survival and recurrence. Patients with recurrence >1 year from primary resection and without gross vascular invasion had a 5-year survival of 81%. There were 17 recurrences with a 3-year recurrence rate of 55%. Conclusions: Second hepatic resection for recurrent hepatocellular cancer is applicable in about 15% of patient with recurrence. The procedure is safe and can achieve excellent results in well-selected patients. Recurrence continues to be a significant problem. (C) 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
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