Treatment of intrahepatic recurrence after hepatectomy for hepatocellular carcinoma
Open Access
- 24 February 2021
- journal article
- research article
- Published by Wiley in Annals of Gastroenterological Surgery
- Vol. 5 (4), 538-552
- https://doi.org/10.1002/ags3.12449
Abstract
Background Prognostic factors after treatment for intrahepatic recurrent hepatocellular carcinoma (RHCC) after hepatic resection (Hx) are controversial. The current study aimed to examine the impact of treatment modality on the prognosis of intrahepatic RHCC following Hx. Methods For control of variables, the subjects were 56 patients who underwent treatment for intrahepatic RHCC, three or fewer tumors, each measuring ≤3 cm in diameter without macroscopic vascular invasion (MVI), between 2000 and 2011. Retreatment consisted of repeat Hx (n = 23), local ablation therapy (n = 11) and transarterial chemoembolization or transcatheter arterial infusion (TACE/TAI) (n = 22). We retrospectively investigated the relation between type of treatment for RHCC and overall survival (OS) as well as disease‐free survival (DFS). Results In multivariate (MV) analysis, the poor prognostic factors in DFS after retreatment consisted of disease‐free interval (DFI) (≤1.5 y) (P = .011), type of retreatment (TACE/TAI) (P = .002), age (P = .0022), perioperative RBC transfusion (P = .025), while those in OS after retreatment were DFI (≤1.5 y) (P < .0001). In evaluation of stratification for type of retreatment, DFS in the repeat Hx group was significantly better than those in the local ablation therapy group or the TACE/TAI group (P = .023 or P < .0001, respectively). Conclusions DFI (≤1.5 y) was an independent poor prognostic factor in both DFS and OS, and repeat Hx for intrahepatic RHCC, few in number and size without MVI, seems to achieve the most reliable local control.Keywords
This publication has 31 references indexed in Scilit:
- Survival in patients with recurrent hepatocellular carcinoma after primary hepatectomy: Comparative effectiveness of treatment modalitiesSurgery, 2012
- A Randomized Trial Comparing Radiofrequency Ablation and Surgical Resection for HCC Conforming to the Milan CriteriaAnnals of Surgery, 2010
- Treatments for hepatocellular carcinoma in elderly patients are as effective as in younger patients: a 20-year multicentre experienceGut, 2010
- Systematic review of neoadjuvant transarterial chemoembolization for resectable hepatocellular carcinomaLiver International, 2009
- Staging of Hepatocellular CarcinomaAnnals of Surgery, 2007
- Recurrence after liver resection for hepatocellular carcinoma: Risk factors, treatment, and outcomesSurgery, 2007
- Partial Hepatectomy With Wide Versus Narrow Resection Margin for Solitary Hepatocellular CarcinomaAnnals of Surgery, 2007
- Implication of Frequent Local Ablation Therapy for Intrahepatic Recurrence in Prolonged Survival of Patients With Hepatocellular Carcinoma Undergoing Hepatic ResectionAnnals of Surgery, 2006
- Recurrent hepatocellular carcinoma after hepatic resection: prognostic factors and long-term outcomeEuropean Journal of Surgical Oncology, 2004
- Selection Criteria for Repeat Hepatectomy in Patients With Recurrent Hepatocellular CarcinomaAnnals of Surgery, 2003