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Liver resection in patients with a history of local ablation for hepatocellular carcinoma has the risk of poor

Yusuke Nishi1, Katsunori Sakamoto1, Mio Uraoka1

  • 1Department of Hepato-Biliary-Pancreatic and Breast Surgery Ehime University Graduate School of Medicine Toon Ehime Japan.

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Summary

Previous local ablation (LA) for hepatocellular carcinoma (HCC) before hepatectomy is linked to poorer survival and increased risk of tumor invasion. This finding highlights potential challenges in managing HCC patients with prior ablation treatments.

Keywords:
hepatectomyhepatocellular carcinomaradiofrequency ablationrecurrence

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Area of Science:

  • Hepatobiliary Surgery
  • Surgical Oncology
  • Gastroenterology

Background:

  • Hepatocellular carcinoma (HCC) is a primary liver malignancy.
  • Local ablation (LA) is a common treatment modality for HCC.
  • The impact of prior LA on outcomes after subsequent hepatectomy requires further investigation.

Purpose of the Study:

  • To evaluate the effect of previous local ablation (LA) on long-term prognosis.
  • To analyze histopathological findings in hepatocellular carcinoma (HCC) patients undergoing hepatectomy after LA.
  • To compare outcomes between patients who underwent post-ablation liver resection (PALR) and those who did not.

Main Methods:

  • Retrospective analysis of 234 HCC patients undergoing initial hepatectomy.
  • Comparison of 39 PALR patients with 195 non-PALR patients.
  • Exclusion of patients with distant metastasis, residual tumors, or mixed HCC.

Main Results:

  • PALR group had more tumors but smaller diameter compared to non-PALR.
  • PALR group showed significantly poorer 5-year overall survival (54.1% vs. 66.9%) and recurrence-free survival (24.7% vs. 37.0%).
  • PALR, elevated AFP, and high DCP levels were independent predictors of pathological serosal invasion.

Conclusions:

  • Hepatectomy following prior LA for HCC is associated with an increased risk of pathological serosal invasion.
  • Patients with a history of LA undergoing hepatectomy face a higher risk of poor survival outcomes.
  • Careful consideration of prior ablation history is crucial for HCC management and prognostic assessment.