Surgical and Oncological Outcomes of Salvage Hepatectomy for Locally Recurrent Hepatocellular Carcinoma after Locoregional Therapy: A Single-Institution Experience

被引：2

作者：

Minagawa, Takuya ^{[1
]}

Itano, Osamu ^{[1
]}

Kitago, Minoru ^{[2
]}

Abe, Yuta ^{[2
]}

Yagi, Hiroshi ^{[2
]}

Hibi, Taizo ^{[3
]}

Shinoda, Masahiro ^{[1
]}

Ojima, Hidenori ^{[4
]}

Sakamoto, Michiie ^{[4
]}

Kitagawa, Yuko ^{[2
]}

机构：

[1] Int Univ Hlth & Welf, Sch Med, Dept Hepatobiliary Pancreat & Gastrointestinal Sur, Chiba 2860124, Japan

[2] Keio Univ, Sch Med, Dept Surg, Tokyo 1608582, Japan

[3] Kumamoto Univ, Grad Sch Med Sci, Dept Pediat Surg & Transplantat, Kumamoto 8608556, Japan

[4] Keio Univ, Sch Med, Dept Pathol, Tokyo 1608582, Japan

来源：

CANCERS | 2023年 / 15卷 / 08期

关键词：

hepatocellular carcinoma; salvage hepatectomy; locoregional therapy; radiofrequency ablation; transarterial chemoembolization; local recurrence; RADIOFREQUENCY ABLATION; HEPATIC RESECTION; SURVIVAL;

D O I：

10.3390/cancers15082320

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Simple Summary For 35 patients with recurrent HCC after primary hepatectomy and 67 patients with recurrent HCC after locoregional therapies, surgical and oncological outcomes were examined. Pathologic review revealed 30 patients with locally recurrent HCC after locoregional therapy (LR-HCC). Background liver function was significantly worse in patients with recurrent HCC after locoregional therapy. Serum levels of AFP and AFP-L3 were significantly higher in patients with LR-HCC. Perioperative morbidities were observed in significantly more patients with recurrent HCC after locoregional therapies. Long-term outcomes of recurrent HCC after locoregional therapies were worse than those after hepatectomy, though there was no prognostic difference according to the recurrence patterns after locoregional therapies. Multivariate analyses showed that prognostic factors for resected recurrent HCC were previous locoregional therapy, multiple HCCs, and portal venous invasion, whereas LR-HCC was not a prognostic factor. In conclusion, salvage hepatectomy for LR-HCC showed worse surgical outcomes but a favorable prognosis. Surgical and oncological outcomes of hepatectomy for recurrent hepatocellular carcinoma (HCC) after locoregional therapy, including locally recurrent HCC (LR-HCC), were examined. Among 273 consecutive patients who underwent hepatectomy for HCC, 102 with recurrent HCC were included and retrospectively reviewed. There were 35 patients with recurrent HCC after primary hepatectomy and 67 with recurrent HCC after locoregional therapies. Pathologic review revealed 30 patients with LR-HCC. Background liver function was significantly worse in patients with recurrent HCC after locoregional therapy (p = 0.002). AFP (p = 0.031) and AFP-L3 (p = 0.033) serum levels were significantly higher in patients with LR-HCC. Perioperative morbidities were significantly more frequently observed with recurrent HCC after locoregional therapies (p = 0.048). Long-term outcomes of recurrent HCC after locoregional therapies were worse than those after hepatectomy, though there was no prognostic difference according to the recurrence patterns after locoregional therapies. Multivariate analyses showed that prognostic factors for resected recurrent HCC were previous locoregional therapy (hazard ratio [HR] 2.0; p = 0.005), multiple HCCs (HR 2.8; p < 0.001), and portal venous invasion (HR 2.3; p = 0.001). LR-HCC was not a prognostic factor. In conclusion, salvage hepatectomy for LR-HCC showed worse surgical outcomes but a favorable prognosis.

引用

页数：14

共 26 条

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