Recurrence of hepatocellular carcinoma after surgery

Abstract

A total of 386 patients who underwent complete resection of hepatocellular carcinoma over an 8-year period were assessed retrospectively for tumour recurrence. Some 219 (56·7 per cent) of the patients developed recurrence. Patients with a greater degree of cirrhosis showed a longer interval to recurrence; the median (range) interval until recurrence was 7·9 (1·8–84·2) months in patients with a normal liver, 13·4 (2·0–79·5) months in those with chronic hepatitis and 16·7 (1·5–73·1) months in those with cirrhosis. Intrahepatic recurrence was observed more frequently in either the same (26-4 per cent) or the adjacent (24·8 per cent) Healey segment than in the lobe contralateral to the primary tumour (17·8 per cent). The presence of portal venous invasion and/or intrahepatic metastasis, underlying liver cirrhosis and perioperative blood transfusion were determined to be independent predictors of recurrence by multivariate analysis. Because intrahepatic spread of hepatocellular carcinoma occurs in a segment-by-segment manner, surgeons should use an anatomically wide resection within the hepatic functional reserve.