REPEATED HEPATIC RESECTION FOR RECURRENT HEPATOCELLULAR-CARCINOMA IN 18 CASES

Background. Although intrahepatic recurrence after hepatic resection for hepatocellular carcinoma is the most significant cause of death, very few reports are available for hepatic re-resection as a radical treatment for recurrence. Methods. Eighteen patients who underwent repeated hepatic resections for hepatocellular carcinoma were evaluated. Most of the patients regularly received measurement of alpha-fetoprotein level once a month and examination by ultrasonography and/or computed tomography scanning once every 3 to 4 months. Results. No operative deaths occurred. The alpha-fetoprotein levels of 9 of the 18 patients were within the normal range. Most patients underwent limited hepatic resection to maintain the remaining hepatic function. The 1-, 3-, and 5-year cumulative survival rates after repeated resection were 88%, 37%, and 37%, respectively. The 3-, 5-, and 7-year survival rates after the first resection were 88%, 68%, and 45%, respectively. These showed no significant difference from the survival rates of patients with no recurrences after hepatic resection. Conclusions. Careful follow-up examinations after hepatic resection are needed for early detection of recurrences, and efforts should be made for repeated hepatic resection, which leads to satisfactory outcome.