Mode of recurrences and multicentric carcinogenesis after resected hepatocellular carcinoma with chronic hepatitis

• Published in: Kanzo Vol. 38; no. 9; pp. 541 - 546
• Main Authors: MAEBA, Takashi, MORI, Seiji, HAMAMOTO, Isao, OKADA, Setsuo, WAKABAYASHI, Hisao, MAETA, Hajime
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society of Hepatology 1997
• ISSN: 0451-4203; 1881-3593
• DOI: 10.2957/kanzo.38.541

Significance of hepatic resection for hepatocellular carcinoma (HCC) with chronic hepatitis (CH), and relation between CH and metachronous multicentric carcinogenesis (MMC) were investigated in view of the mode of recurrences in 36 resected cases. The diagnostic criteria for MMC was instituted as follows; (1) recurred cases after absolute curative resection for early HCC, (2) cases had no histological invasion in the primary tumor and recurred with single tumor in the remnant liver from 3 years later after the operation, (3) recurred cases from 5 years later after the operation, (4) resected recurrent cases whose tumor existed well differentiated carcinoma. Sixty-one % of the subject had stage III and IV advanced HCC. After hepatic resection, the majority of the patients except for one case recurred within 3 years. In the one case recurrence was found 9 years after the surgery in the cirrhotic remnant liver, and this recurrence was conjectured to be due to MMC. Five-years recurrence rate and survival rate after hepatic resection was 37.7% and 70.8%, respectively. These good results were considered to be attributed to followings; (1) major hepatic resection were employed in sixty-four % of all cases, (2) postoperative recurrence arised from MMC was observed in only one case. It is concluded that HCC with CH have the possibility of monocentric carcinogenesis, and major hepatic resection should be employed for HCC, especially for large HCC, with CH.