Prognostic factors after repeat hepatectomy for recurrent hepatocellular carcinoma

The purpose of this study was to determine the poor prognostic factors after repeat hepatectomy (Hx) in patients with recurrent hepatocellular carcinoma (HCC). Overall survival rates and clinicopathological variables in 112 patients with repeat Hx from 1992 to 2010 were compared with those in 531 patients who underwent a primary Hx. To clarify the poor prognosis factors after repeat Hx, survival data among 112 patients were univariately and multivariately analyzed. Overall survival after repeat Hx was similar for that of the patients who underwent a primary Hx. The mean age of repeat Hx group was significantly higher, and a well-preserved liver function was recognized than the primary Hx group. Multivariate analysis revealed that: 1) indocyanine green retention rate at 15 minutes; 2) disease-free interval; 3) tumor size; 4) portal vein invasion at primary Hx; 5) gender; and 6) estimated blood loss to be an independent and significant poor prognostic factors. The overall 3-year postrecurrence overall survival rates were 100, 91.3, 59.6, and 0 per cent at risk number (R) R0, R1/2, R3, R4, respectively ( P < 0.05). Repeat Hx provided a good compatible prognosis with primary Hx. In our findings, five risk factors to predict poor outcomes after repeat Hx were useful. Patients with recurrent HCC do not have universally poor outcomes, and our simple scoring system using five poor prognostic factors could serve to advise the prognosis and the potential benefit for patient selection about repeat Hx.

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Prognostic Factors After Repeat Hepatectomy for Recurrent Hepatocellular Carcinoma

Annals of Surgery ◽

10.1097/00000658-199801000-00012 ◽

1998 ◽

Vol 227 (1) ◽

pp. 80-85 ◽

Cited By ~ 117

Author(s):

Mitsuo Shimada ◽

Kenji Takenaka ◽

Kenichi Taguchi ◽

Yuh Fujiwara ◽

Tomonobu Gion ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Prognostic Factors ◽

Repeat Hepatectomy ◽

Recurrent Hepatocellular Carcinoma

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Antiviral Therapy Inhibits Viral Reactivation and Improves Survival after Repeat Hepatectomy for Hepatitis B Virus-Related Recurrent Hepatocellular Carcinoma

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2016.11.009 ◽

2017 ◽

Vol 224 (3) ◽

pp. 283-293.e4 ◽

Cited By ~ 7

Author(s):

Shengyu Huang ◽

Yong Xia ◽

Zhengqing Lei ◽

Qifei Zou ◽

Jun Li ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Hepatitis B Virus ◽

Hepatitis B ◽

Antiviral Therapy ◽

Viral Reactivation ◽

Repeat Hepatectomy ◽

Recurrent Hepatocellular Carcinoma ◽

B Virus

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Radiofrequency ablation versus repeat hepatectomy in the treatment of recurrent hepatocellular carcinoma in subcapsular location: a retrospective cohort study

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02277-4 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Fuqun Wei ◽

Qizhen Huang ◽

Yang Zhou ◽

Liuping Luo ◽

Yongyi Zeng

Keyword(s):

Hepatocellular Carcinoma ◽

Radiofrequency Ablation ◽

Repeat Hepatectomy ◽

Free Survival ◽

Recurrent Hepatocellular Carcinoma ◽

Primary Endpoints ◽

Grade 3 ◽

Optimal Treatment Strategy ◽

Hepatectomy Group

Abstract Background Repeat hepatectomy and radiofrequency ablation (RFA) are widely used to treat early recurrent hepatocellular carcinoma (RHCC) located in the subcapsular region, but the optimal treatment strategy remains to be controversial. Methods A total of 126 RHCC patients in the subcapsular location after initial radical hepatectomy were included in this study between Dec 2014 and Jan 2018. These patients were divided into the RFA group (46 cases) and the repeat hepatectomy group (80 cases). The primary endpoints include repeat recurrence-free survival (rRFS) and overall survival (OS), and the secondary endpoint was complications. The propensity-score matching (PSM) was conducted to minimize the bias. Complications were evaluated using the Clavien-Dindo classification, and severe complications were defined as classification of complications of ≥grade 3. Results There were no significant differences in the incidence of severe complications were observed between RFA group and repeat hepatectomy group in rRFS and OS both before (1-, 2-, and 3-year rRFS rates were 65.2%, 47.5%, and 33.3% vs 72.5%, 51.2%, and 39.2%, respectively, P = 0.48; 1-, 2-, and 3-year OS rates were 93.5%, 80.2%, and 67.9% vs 93.7%, 75.8%, and 64.2%, respectively, P = 0.92) and after PSM (1-, 2-, and 3-year rRFS rates were 68.6%, 51.0%, and 34.0% vs 71.4%, 42.9%, and 32.3%, respectively, P = 0.78; 1-, 2-, and 3-year OS rates were 94.3%, 82.9%, and 71.4% vs 88.6%, 73.8%, and 59.0%, respectively, P = 0.36). Moreover, no significant differences in the incidence of severe complications were observed between the RFA group and repeat hepatectomy group. Conclusion Both repeat hepatectomy and RFA are shown to be effective and safe for the treatment of RHCC located in the subcapsular region.

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Recurrent hepatocellular carcinoma: comparison between repeat hepatectomy and local ablation

HPB ◽

10.1016/j.hpb.2016.01.495 ◽

2016 ◽

Vol 18 ◽

pp. e865

Author(s):

L. Lacaze ◽

O. Goria ◽

J.P. Lestrat ◽

M. Bubenheim ◽

M. Scotte

Keyword(s):

Hepatocellular Carcinoma ◽

Repeat Hepatectomy ◽

Local Ablation ◽

Recurrent Hepatocellular Carcinoma

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Recurrent hepatocellular carcinoma after hepatic resection: prognostic factors and long-term outcome

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2004.01.013 ◽

2004 ◽

Vol 30 (4) ◽

pp. 414-420 ◽

Cited By ~ 77

Author(s):

W.-T. Chen ◽

G.-Y. Chau ◽

W.-Y. Lui ◽

S.-H. Tsay ◽

K.-L. King ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Prognostic Factors ◽

Hepatic Resection ◽

Term Outcome ◽

Long Term Outcome ◽

Recurrent Hepatocellular Carcinoma

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Transarterial Chemoembolization Combined With Radiofrequency Ablation Versus Repeat Hepatectomy for Recurrent Hepatocellular Carcinoma After Curative Resection: A 10-Year Single-Center Comparative Study

Frontiers in Oncology ◽

10.3389/fonc.2021.713432 ◽

2021 ◽

Vol 11 ◽

Author(s):

Xin Zheng ◽

Yanqiao Ren ◽

Hanqing Hu ◽

Kun Qian

Keyword(s):

Hepatocellular Carcinoma ◽

Radiofrequency Ablation ◽

Transarterial Chemoembolization ◽

Curative Resection ◽

Progression Free Survival ◽

Repeat Hepatectomy ◽

Tumor Diameter ◽

Recurrent Hepatocellular Carcinoma ◽

Significant Difference ◽

Hepatectomy Group

BackgroundThe purpose of this study was to compare the efficacy and safety of transarterial chemoembolization (TACE) in combination with radiofrequency ablation (RFA) (TACE-RFA) and repeat hepatectomy in the treatment of recurrent hepatocellular carcinoma (HCC) after curative resection.MethodsThis retrospective study evaluated consecutive medical records of patients who received either TACE-RFA or repeat hepatectomy between January 2010 and May 2021. Overall survival (OS), progression-free survival (PFS), and complications were compared.ResultsOf the 2672 patients who received either TACE-RFA or repeat hepatectomy, 111 eligible patients were included in our study, 63 in the TACE-RFA group and 48 in the repeat hepatectomy group. The median OS was 38 months in the TACE-RFA group and 42 months in the repeat hepatectomy group, with no statistically difference between the two groups (P=0.45). Meanwhile, there was also no statistically significant difference in PFS between the two groups (P=0.634). Although both groups achieved similar outcomes, the rate of major complications was significantly higher in the repeat hepatectomy group (P=0.003).ConclusionsPatients with recurrent HCC in the TACE-RFA group and the repeat hepatectomy group had similar OS and PFS regardless of the patient’s tumor diameter, but the TACE-RFA group was safer and more minimally invasive.

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