The Discussion Of The Surgical Treatment For Intrahepatic Recurrence After Hepatectomy For Hepatocellular Carcinoma

AimsTo investigate the operative indication and efficacy of Re-resection for intrahepatic recurrence after hepatectomy for hepatocellular carcinoma.MethodsA retrospect study which inclued 60 cases of HCC who hospitalized in our hospital was conducted .All the subjects were diagnosed as the primary Hepatocarcinoma and received gemder rescetion at the first time.30 of them received re-resections,while the others reveived TACE.when the primary Hepatocarcinoma was recurrent.The factors on the prognisis of the primary Hepatocarcinoma and the clinic standard of recurrent Hepatocarcinoma(based on the recurrent time,The tumor size,the number of tumor ,Liver function , hepatocirrhosis degree) of the two groups were analyzed,data show that there was no significant differences(P>0.05)between the two groups.Then the effects on the prognosis of surgical treatment and TACE was analyzed through comparing the survival rate of 1,3,5 year between the two groups.ResultsAll the subjects were followed up.The primary endpoint was death, cox proportional hazard regression model was used to calculate the survival rate, the result indicated that the survival rate of 1,3 and 5 year of the surgical treatment group was significantly higher(P<0.05) than that of the TACE group.The survival rate of 1,3 and 5 year of the surgical treatment group was 78%,34%,20%,respectively ,with the median survival time 31 months ,while in the other group,the result was 53%,28%,14,respectively,with the median survival time 15 months.Conclusions1 Through the analysis of the surgical treatment and TACE on the prognosis of the intrahepatic recurrent Hepatocarcinomas after hepatectomy,we concluded that re-resection was the better treatment to those patients with surgical indications,which changes the past concept that the recurrent primary Hepatocarcinoma was considered as the advanced stage of tumor and surgical treatment should not be taken.2 It is necessary to perfect the preoprative examination to identify the liver function,the tumor size and number, hepatocirrhosis degree and so on, and identify the operative indication.Both the preoperative examinations and the conditions during the operation should be taken into consideration to decide operation type.Local excision or irregular excision of the recurrent tumor was the primary operation type,and the hepatic tissue shoule be reserved as much as posssible to decrease the complications.Through that, the recurrent tumor can be radically excised and prognisis can be improved .3 Re-resection can markedly elevate the survival rate of 1,3,5 year of the patients than TACE.