The treatment of recurrent HCC after hepatectomy is restricted by anatomical changes and reduced hepatic function reserve. In this point of view, MCT under laparotomy and thoracoscopy (MCT-OP) appears a suitable therapeutic method, because it enables total necrosis of recurrent HCC with a minimum risk to the patients. From April 1998 to August 2003, fourteen who developed HCC recurrence in the remnant liver after hepatic resection were treated MCT-OP. Two (14.3%) had a tumor larger than 4 cm in diameter, and 3 (21.4%) had more than 4 in recurrent numbers. Major complication, biloma, occurred in only one case. No local recurrence was seen with all of the cases, but 5 had recurrence at the other regions in the liver. One patient had pulmonary metastasis and was treated by partial lung resection. Twelve patients are alive to date, while the remaining two died of multiple HCC recurrence. In conclusion, MCT-OP is an effective and safe treatment for patients who developed recurrent HCC after hepatectomy.
