Surgical Outcomes of Anatomical Resection for Solitary Recurrent Hepatocellular Carcinoma

Background: For eradicating portal venous tumor extension and intrahepatic metastasis in hepatocellular carcinoma (HCC), anatomical resection is, in theory, preferable. Patients and Methods: We carried-out a retrospective cohort study in 110 patients who underwent curative hepatic resection (anatomical resection; n=20, and limited resection; n=90) for solitary recurrent HCC from 1990-2010. Results: No significant difference was found in short-term surgical results such as mortality, morbidity, and duration of hospital stay between the two groups. Anatomical resection did not influence overall and disease-free survival for all patients with a solitary recurrent HCC. In patients with cancer spread, such as pathological vascular invasion and intrahepatic metastasis (n=61), or with des-gamma-carboxy prothrombin (DCP)>= 100 mAU/ml (n=73), the disease-free survival rate in the anatomical-resection group was significantly better than that in the limited-resection group (p=0.0452 and p=0.0345, respectively). Conclusion: Anatomical resection should be recommended only for HCC suspected of exhibiting cancer spread as reflected by DCP >= 100 mAU/ml in patients with solitary recurrent HCC.