Significance and Problems of Hepatic Resection for Hepatocellular Carcinoma and Borderline Lesions in Termas of Recurrence in the Remnant Liver

Kazuo Hatsuse, Hideki Aoki, Kenji Tsuboi, Michinori Murayama, Takuo Inui, Tsukasa Aihara, Minoru Kakihara, Syoetsu Tamakuma, Shintarou Terahata*

First Department of Surgery, Clinical Laboratory*, Natinal Defense Medical College

This study was carried out to evaluate the significance and problems of hepatic resection for borderline lesions, concomitant with hepatocellular carcinoma (HCC) which were detected by computed tomography during angiography (angio CT), in terms of recurrences within one year of the resection. There were 39 lesions in 20 patients. Eleven of the 20 patients (55%) had multiple lesions including early HCC and borderline lesions that suggested multicentric occurrence. Recurrences in the remnant liver were found in four out of twenty patients (20%) within a year of hepatic resection. There were more recurrences in the remnant liver in patients with multiple lesions than in those with a single lesion. In patients with multiple lesions who underwent relative noncurative resection or operative ethanol injection therapy because lesions occupied bilateral lobes, there were more recurrences in the remnant liver. Recurrences the remnant liver occurred in patients with liver cirrhosis more than in patients with chronic hepatitis. There were many recurrences with multiple lesions. The detection by angio CT of multiple lesions and the resection of as many lesions as possible, contributd to the decrease in the number of recurrences within a year of hepatic resection. However, why there were many multiple recurrences that were impossible to re-operate on after hepatic resection is a question which still remains to be studied.

Key words
liver cirrhosis, hepatocellular carcinoma, early hepatocellular carcinoma, borderline lesions, computed tomography during hepatic arteriography and arterioportography

Reprint requests
Kazuo Hatsuse First Department of Surgery, National Defense Medical College
3-2 Namiki, Tokorozawa, 359 JAPAN

Accepted
July 5, 1995

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