Korean J Hepatobiliary Pancreat Surg.  2012 Aug;16(3):93-97. 10.14701/kjhbps.2012.16.3.93.

Extrahepatic recurrence of hepatocellular carcinoma after curative hepatic resection

• Byeon J
• Cho EH
• Kim SB
• Choi DW

• KMID: 2243213
• DOI: http://doi.org/10.14701/kjhbps.2012.16.3.93

Abstract

BACKGROUNDS/AIMS
This study was designed to compare the recurrence patterns after curative hepatectomy, to compare the prognosis according to the initial site of metastasis, and to investigate the independent predictive factors associated with extrahepatic recurrence in hepatocellular carcinoma (HCC) patients after curative hepatectomy.
METHODS
From January 2000 to July 2009, 307 patients underwent curative hepatectomies for HCC at our institution; 152 patients showed recurrences. Patients were divided into 2 groups according to their initial recurrence site: the intrahepatic recurrence (IHR) group and extrahepatic recurrence (EHR) group. The IHR group was comprised of 111 patients and the EHR group was comprised of 41 patients. The study investigated the preoperative, intraoperative, and postoperative factors related to the recurrence pattern retrospectively and compared the prognoses of the patients.
RESULTS
A five-year survival rate after an initial recurrence was lower in the EHR group (21.5%) than the IHR group (36.3%) (p<0.001). The preoperative alpha-fetoprotein (AFP) level was an independent risk factor for extrahepatic recurrence (p=0.014).
CONCLUSIONS
Patients with a preoperative AFP level greater than 200 ng/ml have a higher incidence of extrahepatic metastases after a curative resection of HCC. Increased level of preoperative AFP is an indication for a short-term follow up hepatectomy.

Keyword

Hepatocellular carcinoma; Hepatectomy; Recurrence

MeSH Terms

alpha-Fetoproteins
Carcinoma, Hepatocellular
Follow-Up Studies
Hepatectomy
Humans
Incidence
Neoplasm Metastasis
Prognosis
Recurrence
Retrospective Studies
Risk Factors
Survival Rate
alpha-Fetoproteins

Figure

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  Fig. 1 Comparison of survival rates between intrahepatic recurrence (IHR) and extrahepatic recurrence (EHR) groups after curative resection of hepatocellular carcinoma. The IHR group shows a better cumulative survival curve than the EHR group. The five-year survival rate of IHR and the EHR groups were 36.3% and 21.5%, respectively.

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