Repeated Hepatic Resection for Recurrent Hepatocellular Carcinoma -In 15 Cases-

Masahiro Suenaga, Yoshikatsu Okada, Hayato Sugiura, Yoshikazu Kokuba, Shinichi Uehara, Takashi Kurumiya, Kikuo Mori, Shigeki Yamaguchi

Surgical Service, Nagoya Medical Hospital

We report the results of repeated hepatic resections for 15 patients with hepatoma. These were 14% of hepatic resections performed for hepatoma, and 25% of intrahepatic recurrence. Fourteen of these patients had co-existing cirrhosis. All of the patients were followed up regularly by measurement of the α-fetoprotein (AFP) level once a month and by ultrasonograpny and/or CT scanning once every 3-4 months. Recurrence was detected in 7 patients with negative AFP level. Almost all of the patients had limited hepatic resection-partial resection. There was no operative mortality. The largest diameter of the tumor was less than 20 mm in 7 patients. Except for 2 patients, resections were performed by using a micro-wave tissue coagulator and an ultrasonic surgical apparatus without vascular clamping at the hepatic hilum. Two patients underwent trans-thoracic and trans-diaphragmatic hepatic resections. The 1-year, 3-year and 5-year cumulative survival rates after repeated hepatic resection were 77%, 37% and 37%. The 1-year, 3-year, 5-year and 7-year cumulative survival rates after the first hepatic resection were 82%, 58%, 49% and 49%. The results show that careful follow-up study is needed for early detection of recurrence and that much effort for repeated hepatic resection leads to a good prognosis for intrahepatic recurrence.

Key words
hepatocellular carcinoma, hepatic resection, recurrent hepatocellular carcinoma, repeated hepatic resection

Reprint requests
Masahiro Suenaga Surgical Service, Nagoya Memorial Hospital
4-305 Hirabari Tenpaku-ku, Nagoya, 468 JAPAN

Accepted
May 31, 1992

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