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Abstract Details
Is hepatic resection for recurrent or persistent hepatocellular carcinoma justified?
Kishi Y, Saiura A, Yamamoto J, Koga R, Seki M, Morimura R, Yoshioka R, Kokudo N, Yamaguch T. Hepatogastroenterology. 2012 Oct;59(119):2255-9. doi: 10.5754/hge10505.
Abstract
Key Words: Hepatocellular carcinoma; Recurrent; Persistent; Hepatic resection. Abbreviations: Hepatocellular Carcinoma (HCC); Recurrent HCC (HCCR); Transarterial Chemoembolization (TACE); Percutaneous Ethanol Injection (PEI); Radiofrequency Ablation (RFA); Hepatitis B Virus Surface Antigen (HBs-Ag); Hepatitis C Virus Antibody (HCVAb); Computed Tomography (CT); Magnetic Resonance Imaging (MRI); Overall Survival (OS); Recurrence Free Survival (RFS).Background/Aims: The safety and effectiveness of hepatic resection for recurrent or refractory hepatocellular is not established, particularly in cases treated by non-surgical treatment. Methodology: Surgical outcomes of 38 patients who underwent curative hepatic resection for recurrent or refractory disease after previous treatment were evaluated. Univariate and multivariate analyses were performed to identify prognostic predictors. Results: There were no postoperative deaths, morbidity occurred in 9 patients (prolonged ascites retention, 5; biliary fistula, 3; intraabdominal abscess, 1), and all of them were treated conservatively. Recurrence-free and overall 1, 3 and 5-year-survival rate was 54, 28 and 24%, and 78, 60 and 55%, respectively. Multivariate analysis revealed hepatitis B or C virus infection (HR=12.8; 95% CI=2.3-245.1), tumor size >5cm (HR=5.9; 95% CI=5.9-25.6), and vasculo- biliary invasion (HR=5.2; 95% CI=1.4-21.0) were independent predictors of poor overall survival. Type of previous treatment did not influence prognosis. Conclusions: Hepatic resection for recurrent or refractory hepatocellular carcinoma is safe and achieves long survival in selected patients.