SURGICAL-TREATMENT OF RECURRENT HEPATOCELLULAR-CARCINOMA

During the last 16 years, radical resection was performed in 392 patie nts with hepatocellular carcinoma (HCC). Eight patients died within 30 days after resection. The other 384 patients were discharged from hos pital and closely followed for 6 to 195 months. By December 1991, 185 patients had developed a recurrent tumor, the 1-, 3-, and 5-year recur rence rates being 15.0%, 45.4%, and 55.3%, respectively. Ninety of the 185 patients underwent reoperation, including second hepatic resectio n (65 cases), cryosurgery (8 cases), resection of lung metastasis (6 c ases), hepatic artery ligation and infusion chemotherapy (2 cases), in tratumor ethanol injection (3 cases), microwave coagulation plus intra tumor ethanol injection (2 cases), and exploration (4 cases). The surv ival rate of these 90 patients was significantly better than that of 9 5 patients who were treated by other palliative methods, the 5-year su rvival rate being 63.4% as compared with 28.6% after the first resecti on (P<0.01), and 40.8% vs. 2.2% after recurrence (P<0.01), respectivel y. These results suggest that reoperation for recurrent HCC might be a n important approach to prolonging survival further after hepatic rese ction.