INDICATIONS FOR, AND EFFECTIVENESS OF, A 2ND HEPATIC RESECTION FOR RECURRENT HEPATOCELLULAR-CARCINOMA

Background/Aims: Second hepatic resection (SHR) for recurrent hepatoce llular carcinoma (HCC) appears to have a better prognosis than other t reatments; however, it is not clear whether this is the result of the procedure, or of the underlying condition of patients undergoing this treatment. Materials and Methods: Consecutive hepatic resection for 13 years, many patients suffered from recurrence in the remnant liver. A fter detection of recurrence, these lesions were treated in various wa ys including SHR. In this communication, recurrent patients were divid ed into SHR patients and non-SHR patients. In these two groups, we ana lyzed clinicopathologically. Results: After 341 curative hepatic resec tions for HCC, recurrences presented in 193 patients (57%). SHR was pe rformed in 32 patients (16%), while the other 162 patients (84%) under went other treatments. At first resection, the group did not significa ntly differ in. sex, age, evidence of hepatitis infection, liver funct ion tests, tumor size, presence of portal vein invasion. and evidence of histologic cirrhosis. SHR patients had more tumor-free days followi ng first resection than non-SHR patients (p <0.05). The survival rate following recurrence for SHR patients was better than. that of non-SHR patients (p <0.05). Among the non-SHR patients, 23 patients met crite ria for the procedure. Survival rate for the 31 SHR patients also was better than that of these 23 patients (p <0.05). Conclusion: Since SHR is safe, effective, and offers an improved prognosis for recurrent HC C, it should be the treatment of choice whenever possible.