BACKGROUND/AIMS: The long-term outcome of patients undergoing repeated hepatectomy for secondary hepatocellular carcinoma (HCC) were investigated to assess the selection criteria for, and efficacy of, repeated hepatectomy. METHODOLOGY: 21 patients with secondary HCC who had undergone repeated hepatectomy (R group) were analyzed. Clinical characteristics, histopathologic findings and postoperative clinical course were compared for patients with primary and secondary HCCs in the R group. The risk factors for post repeated hepatectomy survival and disease-free survival were estimated for the R group. RESULTS: There were no significant differences in patient characteristics or histologic features of primary and secondary HCCs in the R group. A significant difference in cumulative postoperative disease-free survival was not seen for primary and secondary HCCs, average duration was 39.4 and 21.3 months. Liver cirrhosis and narrow hepatectomy (subsegmentectomy, limited resection and enucleation) were found to be significant risk factors of survival after secondary hepatectomy. The 5-year post-recurrence survival rate of nine patients in the R group who had two risk factors was 14.8%. CONCLUSIONS: In cirrhotic patients with secondary HCC, inadequate narrow repeated hepatic resection should not receive repeated hepatectomy.
BACKGROUND/AIMS: The long-term outcome of patients undergoing repeated hepatectomy for secondary hepatocellular carcinoma (HCC) were investigated to assess the selection criteria for, and efficacy of, repeated hepatectomy. METHODOLOGY: 21 patients with secondary HCC who had undergone repeated hepatectomy (R group) were analyzed. Clinical characteristics, histopathologic findings and postoperative clinical course were compared for patients with primary and secondary HCCs in the R group. The risk factors for post repeated hepatectomy survival and disease-free survival were estimated for the R group. RESULTS: There were no significant differences in patient characteristics or histologic features of primary and secondary HCCs in the R group. A significant difference in cumulative postoperative disease-free survival was not seen for primary and secondary HCCs, average duration was 39.4 and 21.3 months. Liver cirrhosis and narrow hepatectomy (subsegmentectomy, limited resection and enucleation) were found to be significant risk factors of survival after secondary hepatectomy. The 5-year post-recurrence survival rate of nine patients in the R group who had two risk factors was 14.8%. CONCLUSIONS: In cirrhotic patients with secondary HCC, inadequate narrow repeated hepatic resection should not receive repeated hepatectomy.