Postoperative Recurrence of Hepatocellular Carcinoma

Abstract

The postoperative intrahepatic remnant rate is very high; 80% by 5 years after resection. The preoperative serum alpha-fetoprotein level and adequacy of the cut margin significantly influenced the recurrence rate.

Liver resection for hepatocellular carcinoma in patients who have undergone prior renal transplantation

“…As previously reported [11][12][13][14][15][16], all patients with HCC admitted for evaluation for liver resection underwent a liver function examination (including Child-Pugh grading [21]), serum a-fetoprotein (AFP) test, indocyanine-green (ICG) clearance test, and imaging studies (including abdominal ultrasonography, computed tomography (CT), and angiography) [11][12][13][14][15][16]. Serum hepatitis B surface antigen (HBsAg) and anti-hepatitis C antibody (HCV-Ab) were checked in every patient [14].…”

“…In contrast, to perform radical surgery on a malignant tumor, the resection margin for cancer should be as wide as possible (usually 1 cm) [16,17]. However, the width of resection margin for HCC remains controversial because the tumor characteristics greatly influence the prognosis [11,12,15,18].…”

Novel Aspects of the Liver Microenvironment in Hepatocellular Carcinoma Pathogenesis and Development

“…Even when HCC is detected in early stages, post-treatment recurrence is common and occurs in ~15% of patients treated with liver transplant [40,41,42], and ~60% of patients treated with partial resection with curative intent [43,44,45,46]. The median 5-year survival rate after recurrence is ~20%–35% [47,48,49,50].…”

Postoperative Outcomes in Patients With Hepatocellular Carcinomas Resected With Exposure of the Tumor Surface

“…Using a wide resection margin to ensure histological clearance is a general principle of surgical oncology, but its significance for HCC resections has remained controversial despite extensive studies. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] There is no consensus regarding the definition of adequate surgical margins for curative operations for HCCs associated with cirrhosis. 20 Hepatic surgeons often encounter tumors that are centrally located and close to the large intrahepatic vascular structures.…”

“…2007;142 (7):596-602 R ESECTION MARGIN HAS BEEN widelyexaminedforitseffect on the postoperative outcome of patients with hepatocellularcarcinoma(HCC), but its significance remains controversial. A few studies have shown that a resection margin smaller than 1 cm was an adverse prognostic factor for long-term survival, [1][2][3][4][5][6][7][8] butothershavefoundnocorrelationbetween the width of the resection margin and longterm outcome. [9][10][11][12][13][14][15][16][17][18][19] These seemingly conflicting results have resulted in a discrepancy among hepatic surgeons on the definition of curative resection for HCC.…”