Second and third hepatectomies for recurrent hepatocellular carcinoma are justified

Abstract

Second and third hepatectomies seem justified for hepatic recurrence of HCC. The role of fourth hepatectomy needs further investigation.

Hepatocellular Carcinoma Recurring in the Opposite Lobe Nine Years After Regular Right Hepatectomy

“…This situation places hepatectomy to the agenda again. In a study covering 1177 HCC cases conducted by C. Wu et al, it was stated that 149 patients had a second, 35 patients had a third, and 8 patients had a fourth hepatectomy and the authors argued that 2nd and 3rd hepatectomies increased the chance of survival (6). Our case in this article had a regular right hepatectomy 9 years ago and a recurrence was detected in the left lobe's lateral segment 9 years after the procedure.…”

Surgical Management of Primary Hepatocellular Carcinoma

“…Although repeat hepatectomy could be a difficulty owing to perihepatic adhesion related to first operation, surgical resection remains a preferred treatment whenever the tumor is considered to be resectable [67][68][69].…”

Treatment Strategy for Recurrent Hepatocellular Carcinoma

“…Repeat hepatic resection has been widely recognised as one of the most effective treatments for intra-hepatic recurrent HCC compared to other therapeutic modalities (Chen et al, 2004;Itamoto et al, 2007;Minagawa et al, 2003;Sugimachi et al, 2001;Tralhao et al, 2007;Wu et al, 2009;Zhou et al, 2010). It should be the treatment of choice in suitable patients with preserved liver function and functional status.…”

“…With better understanding of the mechanism of hepatocarcinogenesis, effective molecularly targeted agents, such as sorafenib, have been emerged and improved survival benefits have been demonstrated in large, placebo-controlled phase III trials in Europe and Asia for patients with advanced HCC (Cheng et al, 2009;Llovet et al, 2008). While some may criticize that the benefit gained from sorafenib over placebo in patients with extra-hepatic metastasis from HCC was marginal only, the extra months gain may well be extremely valuable to patients.…”

“…Increased survival rates after aggressive treatment of post-resection HCC recurrence have been reported (Itamoto et al, 2007;Matsuda et al, 2001;Sugimachi et al, 2001;Tralhao et al, 2007;Wu et al, 2009;Zhou et al, 2010). Currently, various therapeutic modalities such as repeat hepatectomy, local ablation therapy and transcatheter arterial chemoembolization (TACE) have been used to treat recurrent HCC.…”