A Study on Recurrent Patterns of Hepatoma in the Remnant Liver

Minoru Nakamoto, Masaru Naruse, Satoru Yanagisawa, Haruyuki Akita, Yoichi Tohyama, Yoshinori Inagaki, Tsuneo Takahashi, Kaoru Mizusaki, Takemasa Chyo, Teruaki Aoki

Second Department of Surgery, The Jiki University School of Medicine

Over the past 12 years, 108 cases of hepatocellular carcinoma were operated on. The factors that determined the course of the recurrence pattern after hepatic resection were studied. There were 23 recurrent cases, a rate of 60.5%. Recurrence patterns were divided into three types as follows: 1. recurrence in the cut surface, 2. solitary type, 3. multicentric type. Recurrence period of solitary and multicenric recurrence type were 1000±66.7 days and 566±511 days. And there was statistically no difference between them. However, the survival period for the solitary type of 472±237 days after confirmation of recurrence was statistically longer than for the multicentric type of 238±130 days. As hazardous factors of recurrence, the infiltration to the capsule of the hepatoma, the infiltration to the portal vein, tumor size, grade of liver cirrhosis, Edmondson's calassification and grade of stage could not predict the recurrence pattern. The factors for estimation of the multicentric recurrence pattern were presence of HBs antigen (38.5%), low rate of reduction of the alpha-fetoprotein (AFP) value (52.5%) after hepatic resection, and multiple tumors in the primary lesion. Preoperative multi-farious treatment could not control the recurrence pattern.

Key words
hepatocellular carcinoma, hepatic resection, liver cirrhosis, alpha-fetoprotein

Reprint requests
Minoru Nakamoto Second Department of Surgery, The Jikei University School of Medicine
3-25-8, Nishishinbashi, Minato-ku, Tokyo 105 JAPAN

Accepted
July 10, 1990

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