INTRAHEPATIC RECURRENT MODES AND THERAPY OF HEPATOCELLULAR CARCINOMA

Abstract

Cumulative recurrence rate and modes of intrahepatic recurrence were studied on 59 patients underwent curative and relative curative hepatectomies. Intrahepatic recurrences were occurred in 24 patients (40.7%) and the cumulative recurrence rate was significantly higher in patients underwent noncurative hepatectomies, and in those with large tumor sizes (>3cm in diameter)and positive tumor invasion to the portal vein at the time of hepatectomy. Eight solitary intrahepatic and 16 multipe intrahepatic recurrences were noted. Relevant factors to multiple recurrent modes included factor T, stages and positive tumor embolus in the portal vein. In all solitary recurrent cases including 3 resection cases, active regional therapies such as transcatheter arterial embolization and continuous intrahepatic arterial infusion chemotherapy were successfully performed. In the multiple recurrent cases, however 7 cases could not receive such regional therapies but only systemic chemotherapy because of impaired liver function. Cumulative survival rate after recurrence in patients with solitary recurrences was significantly better than those in multiple ones. Regional therapies are effective in prolonging the survival period of patients bearing intrahepatic recurrences after hepatectomy.