再発形態と再切除例の長期成績からみた再発肝細胞癌に対する外科治療

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  • SURGICAL TREATMENT OF RECURRENT HEPATOCELLULAR CARCINOMA AFTER HEPATIC RESECTION IN TERMS OF MODES OF RECURRENCE AND LONG-TERM RESULTS OF RE-RESECTED CASES

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This study deals with the indication and significance of surgical therapy for recurred hepatocellular carcinoma in terms of comparison of prognoses by modes of recurrence and long-term therapeutic results after re-hepatectomy. Subjects were 79 recurred cases after hepatectomy. For comparison, the survival rates after recurrence were calculated by the following five items; time from operation to recurrence, the existence of extrahepatic growth, mode of recurrence in the remnant liver, recurred site in the remnant liver, and therapy after recurrence. As a result, significantly better prognoses were noted in recurrences after 2 years of time lapse following hepatectomy, no extrahepatic growth, solitary cases, and re-resected cases. No significant difference was observed between the sites of recurrence in the remnant liver, namely isolateral and counterlateral lobes. In 11 re-resected cases which involved only three cases suspected of heterochronous multicentric carcinoma, a mean survival time after re-resection of solitary recurrence in the remnant liver was as good as 5.2 years. And five patients of them have not experienced re-recurrence for 5 years after the re-resection.<br> It is thought that re-resection can be considered aggressively in patients with two factors, namely, recurrence after 2 years following hepatectomy and solitary recurrence in the hepatic remnant. And the re-resection which provides favorable prognosis appears to be significant for such cases.

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