Analysis Of Repeated Hepatectomy For Recurrent Hcc

Objective To evaluate the efficacy and analyze of the prognosticfactors of repeated hepatectomy for recurrent HCC, providing evidence formanagement of recurrent HCC to improve outcome.Methods The clinical data of26patients who underwent repeatedhepatectomy for recurrent HCC in the first affiliated hospital of ChongqingMedical University, between July2006and Sep2013, were analyzedretrospectively，compared with the efficacy of RFA. Log-Rank test wasused to compare the survival rate and disease free survival rate, ANOVAwas used to compare the blood loss, operative time between the first andthe second hepatectomy. The prognostic factors were also analyzed.Results Repeated irregular excision hepatectomy was the mainsurgical approach for repeated hepatectomy. The total median survival timeafter repeated hepatectomy was40.0months (6~73months), the1,3and5years total survival rates were83.5%,55.7%,13.2%. After RFA, thetotal median survival time was28.0months (5~47months), the1,3and5years total survival rates were85.2%,30.0%,0%, comparison wasstatistically significant. After first resection, median disease-free survival time was23.0months (5~52months), the1,3,5year disease-free survivalrates were76.9%,14.1%,0%. After repeated hepatectomy, disease-freesurvival time was19.0months(3~35months), the1,3,5year disease-freesurvival rates were68.4%,0%,0%, comparison was statistically significant.No obvious difference was found between blood loss, operative time inthese operations.Conclusions Repeated hepatectomy can improve the overall survivalrate of the recurrent liver cancer, the efficacy of repeated hepatectomy wasbetter than RFA,but we should select indications and surgical optionsstrictly. After repeated hepatectomy, disease-free survival time was shorter.The longer of the disease free survival time and local recurrence, radicalresection indicated the better prognosis of the repeated hepatectomy.