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Long-Term Outcomes of Repeat Hepatic Resection in Patients with Recurrent Hepatocellular Carcinoma and Analysis of Recurrent Types and Their Prognosis: A Single-Center Experience in China

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Recurrent hepatocellular carcinoma (HCC) after curative resection usually originates from intrahepatic metastasis (IM) or multicentric occurrence (MO). The long-term outcomes of repeat hepatic resection in patients with different types of recurrence have not been evaluated in a large number of patients. The surgical indications for recurrent HCC remain controversial. The purpose of this study was to investigate long-term outcomes of repeat hepatic resection and clinicopathologic factors associated with different types of recurrent HCC, and to single out principle differentiating factors between IM and MO.

Methods

82 patients who underwent repeat hepatic resection for recurrent HCC were retrospectively studied. The recurrent type was evaluated by histopathologic analysis of primary and recurrent HCC. The recurrence and survival rates as well as clinicopathologic factors associated with different types of recurrence were analyzed.

Results

45 patients (54.9%) had confirmed with IM, and 37 patients (45.1%) had with MO. The recurrence rates in the MO patients after initial or repeat resection were significantly lower than those in the IM patients (p < 0.001). The overall survival rates in the MO patients after initial or repeat resection were significantly higher than those in the IM patients (p < 0.001). Recurrence-free time was identified as the most significant differentiating factor between IM and MO. A recurrence-free time of 18 months after initial resection was a significant cutoff time point for differentiating between IM and MO. A recurrence-free time of less than or equal to 18 months and microvascular invasion at repeat resection were independent adverse prognostic factors for overall survival after repeat hepatic resection.

Conclusions

Repeat hepatic resection resulted in much higher survival rates in the MO patients than in the IM patients. Repeat hepatic resection could be recommended for those patients in whom the recurrent HCC occurs more than 18 months after initial resection.

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Acknowledgment

The authors thank Dr. Peng-Cheng Zhu and Dr. Cong Liu, Department of Pathology, Tongji Hospital, Huazhong Science and Technology University, China, for help in the pathological study. This work was supported by funding from the National Natural Science Foundation of China (No. 81172293; No. 30972901) and the New Centaury Excellent Talent Foundation of China Ministry of Education (No. NCET-04-0701) to Dr. Zhi-Yong Huang, and by grants from the state key project on infection disease of China (Grant No. 2012ZX10002016-004 and 2012ZX10002010-001-004), the Chinese Ministry of Public Health for Key Clinical Projects (No. [2010] 493–51) and Hubei Province for the Clinical Medicine Research Centre of Hepatic Surgery (2007) to Prof Xiao-ping Chen.

Financial Support

This work was supported by funding from the National Natural Science Foundation of China (No. 81172293; No. 30972901) and the New Centaury Excellent Talent Foundation of China Ministry of Education (No. NCET-04-0701) to Dr. Zhi-yong Huang, and by grants from the state key project on infection disease of China (Grant No. 2012ZX10002016-004 and 2012ZX10002010-001-004), the Chinese Ministry of Public Health for Key Clinical Projects (No. [2010] 493–51) and Hubei Province for the Clinical Medicine Research Centre of Hepatic Surgery (2007) to Prof. Xiao-ping Chen.

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Authors and Affiliations

  1. Research Laboratory and Hepatic Surgery Center, Department of Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Zhi-yong Huang MD, Bin-yong Liang MD, Da-qian Zhan MD, Shuang Wei MD, Yi-fa Chen MD & Xiao-ping Chen MD

  2. Department of Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Min Xiong MD

  3. Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Guo-ping Wang MD

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  1. Zhi-yong Huang MD
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Correspondence to Xiao-ping Chen MD.

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Zhi-yong Huang and Bin-yong Liang contributed equally to this work.

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Huang, Zy., Liang, By., Xiong, M. et al. Long-Term Outcomes of Repeat Hepatic Resection in Patients with Recurrent Hepatocellular Carcinoma and Analysis of Recurrent Types and Their Prognosis: A Single-Center Experience in China. Ann Surg Oncol 19, 2515–2525 (2012). https://doi.org/10.1245/s10434-012-2269-7

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  • DOI: https://doi.org/10.1245/s10434-012-2269-7

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