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Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
Published on: March 10, 2023
Third or more repeat hepatectomy for recurrent hepatocellular carcinoma.
Yo-ichi Yamashita1, Ken Shirabe, Eiji Tsuijita
1Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima, Japan; Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Surgery
|August 27, 2013
Summary
Third or more repeat hepatectomy for recurrent hepatocellular carcinoma (HCC) is safe and offers survival benefits. While justified, the high recurrence rate of HCC remains a significant challenge for patients undergoing repeat liver surgery.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Gastroenterology
Background:
- The efficacy of repeat hepatectomy for recurrent hepatocellular carcinoma (HCC) is debated, particularly for third or more procedures.
- Evaluating surgical outcomes for extensive repeat hepatectomy is crucial for patient management.
Purpose of the Study:
- To assess the safety and survival outcomes of third or more repeat hepatectomy for recurrent HCC.
- To compare surgical results across different numbers of repeat hepatectomies for HCC.
Main Methods:
- A retrospective cohort study analyzed 1,000 hepatectomies for HCC from 1989-2011.
- Patients were grouped into first (n=791), second (n=163), and third or more (n=46) hepatectomy cohorts.
- Surgical outcomes and prognoses were compared between groups.
Main Results:
- No significant differences in early surgical mortality or morbidity were observed across the three groups.
- Five-year survival rates were 67% (first), 60% (second), and 43% (third or more hepatectomy).
- Disease-free survival showed a significant difference, with 5-year rates of 37% (first), 29% (second), and 18% (third or more hepatectomy).
Conclusions:
- Third or more repeat hepatectomy for recurrent HCC can be performed safely.
- This procedure is associated with relatively long-term survival, suggesting it may be justified.
- The high rate of HCC recurrence post-repeat hepatectomy remains a critical issue to address.
