Repeat hepatic resection for recurrent hepatocellular carcinoma.

During the last 12 years, hepatic resection was carried out on 268 patients with a diagnosis of hepatocellular carcinoma. Of these, 78% developed tumor recurrence in the remaining liver within 5 years. The indications for repeat hepatectomy were evaluated in the same way as for the first operation. Eighteen second hepatic resections and six third hepatic resections were performed 4 to 63 months after the first hepatectomy, with no operative deaths. The cumulative survival rate of these 24 patients was 87.1% at 3 years, 87.1% at 5 years and 72.6% at 7 years after the first hepatic resection, respectively. The present results show that repeat hepatectomy can be safely indicated for recurrent tumors in patients whose liver functional status has been relatively stable since the first hepatic resection.