Third or more repeat hepatectomy for recurrent hepatocellular carcinoma

• Published in: Surgery Vol. 154; no. 5; pp. 1038 - 1045
• Main Authors: Yamashita, Yo-ichi, MD, PhD, Shirabe, Ken, MD, PhD, FACS, Tsuijita, Eiji, MD, PhD, Takeishi, Kazuki, MD, Ikegami, Toru, MD, PhD, Yoshizumi, Tomoharu, MD, PhD, Soejima, Yuji, MD, PhD, FACS, Ikeda, Tetsuo, MD, PhD, Utsunomiya, Tohru, MD, PhD, Maehara, Yoshihiko, MD, PhD, FACS
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.11.2013
• Subjects: Aged; Aged, 80 and over; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Disease-Free Survival; Female; Hepatectomy - mortality; Hepatectomy - statistics & numerical data; Humans; Japan - epidemiology; Liver - pathology; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Male; Middle Aged; Recurrence; Reoperation - statistics & numerical data; Retrospective Studies; Surgery; Japan
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2013.04.046

Background We sought to evaluate the surgical results of third or more repeat hepatectomy for recurrent hepatocellular carcinoma (HCC). The role of repeat hepatectomy for recurrent HCC, especially in cases with third or more repeat hepatectomy, is controversial. Methods We performed A retrospective, cohort study to analyze the surgical results of repeat hepatectomy performed at a single medical center from 1989 to 2011. A total of 1,000 hepatectomies for HCC were divided into 3 groups: A first hepatectomy group ( n = 791), second hepatectomy group ( n = 163), and third or more hepatectomy group ( n = 46). Operative results and patient prognoses were compared among the 3 groups. Results There were no differences in early surgical results such as mortality and morbidity among the 3 groups. The 5-year survival rates after the first, second, and third or more hepatectomy were 67%, 60%, and 43%, respectively ( P = .1913). There was a significant difference in disease-free survival among the 3 groups, and the 5-year disease-free survival rates after first, second, and third or more hepatectomy were 37%, 29%, and 18%, respectively ( P = .0169). Conclusion Third or more repeat hepatectomy for recurrent HCC was performed safely and associated with relatively long-term survival. Third or more repeat hepatectomy for recurrent HCC seems justified, but high rate of HCC recurrence remains a problem.