Prognosis after intrahepatic recurrence in the patients who underwent curative resection for hepatocellular carcinoma

다국어 초록 (Multilingual Abstract)

Backgrounds/Aims: Intrahepatic recurrence is frequent result after hepatectomy for hepatocellular carcinoma (HCC). We analyzed the clinical results of patients who had the intrahepatic recurrences of HCC after curative surgical resections. Methods: From January 2009 to December 2016, 320 patients underwent curative surgical resection for HCC in department of Surgery, Korea Cancer Center Hospital. After surgical resection, 155 patients had suffered HCC recurrence during follow-up period. Among them, 122 patients had only intrahepatic recurrence initially, who were included in this retrospective study. We analyzed about the period of the recurrence after surgery, treatment methods for the recurred tumors, and poor prognostic factors for survival after intrahepatic recurrences. Results: Among the 122 patients, 83 patients had recurrence within 24 months after surgery. Thirty-eight patients underwent curative treatment for the recurred tumors (re-resection in 18, radiofrequency ablation in 20 patients). Non-curative treatments were performed in 77 patients (TACE in 68 patients, radiotherapy in 9 patients) and conservative management in 7 patients. Five-year survival rate of patients who underwent curative treatment is 86.4% (p≤0.001). Five-year survival rate of non-curative treatment is 55.7% (p≤0.001), conservative management is 0% (p=0.021). Among the clinical factors, non-curative treatment for recurred tumor, AFP level at the time of recurrence, size of recurred tumor were independent poor prognostic factors for survival after intrahepatic recurrences (p＜0.001). Conclusions: For the patients who had intrahepatic recurrent HCC after surgery, aggressive local treatment can improve the prognosis in selective cases. Further study is necessary to validate this retrospective investigation.

목차 (Table of Contents)

• INTRODUCTION
• MATERIALS AND METHODS
• RESULTS
• DISCUSSION
• REFERENCES

참고문헌 (Reference)

1 Livraghi T, "Treatment options in hepatocellular carcinoma today" 100 : 22-29, 2011

2 Huang WY, "Stereotactic body radiation therapy in recurrent hepatocellular carcinoma" 84 : 355-361, 2012

3 Hanazaki K, "Risk factors of intrahepatic recurrence after curative resection of hepatocellular carcinoma" 52 : 580-586, 2005

4 Imamura H, "Risk factors contributing to early and late phase intrahepatic recurrence of hepatocellular carcinoma after hepatectomy" 38 : 200-207, 2003

5 Kew MC, "Recurrence of hepatocellular carcinoma after surgery : can it be avoided" 24 : 741-742, 1996

6 Choi GH, "Prognostic factors and optimal treatment strategy for intrahepatic nodular recurrence after curative resection of hepatocellular carcinoma" 15 : 618-629, 2008

7 Kawano Y, "Prognosis of patients with intrahepatic recurrence after hepatic resection for hepatocellular carcinoma : a retrospective study" 35 : 174-179, 2009

8 Cha C, "Predictors and patterns of recurrence after resection of hepatocellular carcinoma" 197 : 753-758, 2003

9 Matsumata T, "Patterns of intrahepatic recurrence after curative resection of hepatocellular carcinoma" 9 : 457-460, 1989

10 Notake T, "Nomogram predicting long-term survival after the diagnosis of intrahepatic recurrence of hepatocellular carcinoma following an initial liver resection" 22 : 715-725, 2017

11 Poon RT, "Intrahepatic recurrence after curative resection of hepatocellular carcinoma : long-term results of treatment and prognostic factors" 229 : 216-222, 1999

12 Taura K, "Implication of frequent local ablation therapy for intrahepatic recurrence in prolonged survival of patients with hepatocellular carcinoma undergoing hepatic resection : an analysis of 610 patients over 16 years old" 244 : 265-273, 2006

13 Jang WI, "High-dose stereotactic body radiotherapy correlates increased local control and overall survival in patients with inoperable hepatocellular carcinoma" 8 : 250-, 2013

14 Hirokawa F, "Appropriate treatment strategy for intrahepatic recurrence after curative hepatectomy for hepatocellular carcinoma" 15 : 1182-1187, 2011

15 Shimada K, "Analysis of prognostic factors affecting survival after initial recurrence and treatment efficacy for recurrence in patients undergoing potentially curative hepatectomy for hepatocellular carcinoma" 14 : 2337-2347, 2007

16 Umeda Y, "A prognostic model and treatment strategy for intrahepatic recurrence of hepatocellular carcinoma after curative resection" 35 : 170-177, 2011

17 Jang WI, "A phase 2 multicenter study of stereotactic body radiotherapy for hepatocellular carcinoma : safety and efficacy" 126 : 363-372, 2020