Recurrent form of hepatocellular carcinoma after partial hepatic resection.

An analysis of 27 recurrent cases after partial hepatic resection for hepatocellular carcinoma, closely followed-up with various diagnostic imagings, is reported. The patients comprised 22 males and 5 females. Their ages ranged from 34 to 76 years, with an average of 57.8 years. Twenty-five had underlying cirrhosis and 2 presented chronic hepatitis histologically. The 27 patients were classified into the following three types. Type I comprised 18 patients with local recurrence. Local recurrence means that the tumor recurred in an adjacent segment to that initially affected or in the same segment. Thirteen of these patients had a recurrence within a year-after the initial operation. Type II comprised 6 cases of multiple intrahepatic metastases, and Type III 3 cases which were thought to represent a metachronous occurrence. Five of the 6 cases of Type II had multiple intrahepatic metastases within 3 months after the initial operation. The results of the present series indicate that when patients with hepatocellular carcinoma are operated on, manipulation should be as careful as possible in order not to disperse the cancer cells, and close follow-up with imagings more than once every three months, especially in the first year after the initial operation should be ensured wherever possible.