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Recurrence after resection of hepatocellular carcinoma
Bai-Yong Shen1, Hong-Wei Li, J-M Regimbeau
1Department of Surgery, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China. baiyongshen@hotmail.com
Objective:
To assess the relevant factors of prognosis and the proper treatment of recurrent hepatocellular carcinoma (HCC).
Methods:
From January 1983 to January 1997, 135 patients with recurrent HCC were analyzed in terms of host condition, tumor characteristics, and surgical procedures. Surgical treatments of these patients were compared.
Results:
Alpha-fetoprotein (AFP) level >1000 microg/L in the initial operation, tumor size larger than 5 cm in diameter, tumor embolization in the portal veins, 0 surgical margin, and no chemoembolization before the operation were the main factors directly affecting the prognosis in a year after recurrence. Repeat hepatectomy and liver transplantation were performed to obtain better results.
Conclusions:
Tumor characteristics and surgical treatment are the main factors affecting the prognosis after the recurrence of HCC. Liver transplantation plays an important role in patients with poor liver function or multi-recurrent sites.