Repeated Hepatic Resection for Recurrent Hepatocellular Carcinoma - In 15 Cases.

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  • 肝細胞癌切除後の肝再発に対する再切除１５例の検討

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Abstract

We report the results of repeated hepatic resections for 15 patients with hepatoma. These were 14% of hepatic resections performed for hepatoma, and 25% of intrahepatic recurrence. Fourteen of these patients had co-existing cirrhosis. All of the patients were followed up regularly by measurement of the α-fetoprotein (AFP) level once a month and by ultrasonograpny and/or CT scanning once every 3-4 months. Recurrence was detected in 7 patients with negative AFP level. Almost all of the patients had limited hepatic resection-partial resection. There was no operative mortality. The largest diameter of the tumor was less than 20mm in 7 patients. Except for 2 patients, resections were performed by using a micro-wave tissue coagulator and an ultrasonic surgical apparatus without vascular clamping at the hepatic hilum, Two patients underwent trans-thoracic and trans-diaphragmatic hepatic resections. The 1-year, 3-year and 5-year cumulative survival rates after repeated hepatic resection were 77%, 37% and 37%. The 1-year, 3-year, 5-year and 7-year cumulative survival rates after the first hepatic resection were 82%, 58%, 49% and 49%. The results show that careful follow-up study is needed for early detection of recurrence and that much effort for repeated hepatic resection leads to a good prognosis for intrahepatic recurrence.

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