[Three cases of surgical resection of peritoneal recurrence of hepatocellular carcinoma following hepatectomy].

Surgical treatment of peritoneal recurrence (PR) of hepatocellular carcinoma (HCC) is still controversial. We report herein 3 cases of PR treated by surgical resection. Firstly, a 55-year-old woman presented with recurrences in the peritoneum and mediastinal lymph nodes 12 months after hepatectomy for ruptured HCC. After the administration of sorafenib, the mediastinal lesions shrank and the PRs were resected. There has been no recurrence 20 months after PR resection. The second case was of a 56-year-old man with recurrences in the remnant liver and the peritoneum 41 months after hepatectomy for ruptured HCC. The remnant liver lesions were controlled by transcatheter arterial chemoembolization (TACE), and the PRs were resected twice. However, multiple bone and lung metastases developed and the patient died of HCC 73 months after peritoneal resection. In the third case, a 63-year-old man had recurrences in the remnant liver and the peritoneum 78 months after hepatectomy. Remnant liver lesions were controlled by radiofrequency ablation (RFA) and TACE, and PRs were resected. However, the hepatic lesions had progressed and he died 102 months after initial hepatectomy. Based on our observations, patients with PRs who have no other distant metastases and whose intrahepatic lesions are controllable and PRs are completely resectable may have relatively long-term survival. Surgical treatment of PR may also improve the quality of life and prognosis.