Sugimachi K, Maehara S, Tanaka S, Shimada M, Sugimachi K
Department of Surgical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
J Hepatobiliary Pancreat Surg. 2001;8(5):410-6. doi: 10.1007/s005340100002.
Hepatic resection has been regarded as a curative treatment for primary hepatocellular carcinoma (HCC), but a high incidence of postoperative recurrence is general. Thus it is important to predict the patterns of recurrence and select the appropriate treatment for recurrence for a better long-term prognosis of patients with HCC. Clinicopathological studies on 80 patients with intrahepatic recurrence after curative hepatectomy suggested that nodular-type recurrence with up to three nodules is mainly due to metachronous multicentric hepatocarcinogenesis rather than intrahepatic metastases. We reviewed 300 patients with recurrent HCC, and repeat hepatectomy was done in 78 cases (26.0%). The 3- and 5-year survival rates after repeat hepatectomy were 82.8% and 47.5%, respectively, showing better prognosis than those for other treatments. Repeat hepatectomy is the preferred treatment offering a hope of long-term survival for patients with recurrent HCC as long as liver function is sufficient; thus early detection of recurrence should be ensured.
肝切除术一直被视为原发性肝细胞癌（HCC）的一种根治性治疗方法，但术后复发率普遍较高。因此，预测复发模式并为复发选择合适的治疗方法对于改善HCC患者的长期预后非常重要。对80例根治性肝切除术后肝内复发患者的临床病理研究表明，结节型复发且结节数不超过3个主要是由于异时多中心肝癌发生，而非肝内转移。我们回顾了300例复发性HCC患者，其中78例（26.0%）接受了再次肝切除术。再次肝切除术后的3年和5年生存率分别为82.8%和47.5%，显示出比其他治疗方法更好的预后。只要肝功能足够，再次肝切除术是为复发性HCC患者提供长期生存希望的首选治疗方法；因此应确保早期发现复发。
