Survival outcome of salvage hepatectomy in patients with local, recurrent hepatocellular carcinoma who underwent radiofrequency ablation as their first treatment

Background Local recurrence is a specific problem after radiofrequency ablation of small hepatocellular carcinoma, and additional treatment is an important issue. We aimed to investigate the outcome of salvage hepatectomy in patients who develop local, recurrent hepatocellular carcinoma after treatm...

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Bibliographic Details
Published in:Surgery 2016-09, Vol.160 (3), p.661-670
Main Authors: Ueno, Masaki, MD, PhD, Nakai, Takuya, MD, PhD, Hayashi, Michihiro, MD, PhD, Hirokawa, Fumitoshi, MD, PhD, Nagano, Hiroaki, MD, PhD, Wada, Hiroshi, MD, PhD, Kaibori, Masaki, MD, PhD, Matsui, Kosuke, MD, PhD, Tanaka, Shogo, MD, PhD, Yamaue, Hiroki, MD, PhD, Kubo, Shoji, MD, PhD
Format: Article
Language:English
Subjects:
Aged
Carcinoma, Hepatocellular - mortality
Carcinoma, Hepatocellular - surgery
Catheter Ablation
Female
Hepatectomy
Humans
Liver Neoplasms - mortality
Liver Neoplasms - surgery
Male
Middle Aged
Neoplasm Recurrence, Local - mortality
Neoplasm Recurrence, Local - surgery
Retrospective Studies
Salvage Therapy
Surgery
Survival Rate
Treatment Outcome
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Summary:Background Local recurrence is a specific problem after radiofrequency ablation of small hepatocellular carcinoma, and additional treatment is an important issue. We aimed to investigate the outcome of salvage hepatectomy in patients who develop local, recurrent hepatocellular carcinoma after treatment with radiofrequency ablation. Methods From 2001–2013, we reviewed 58 patients from 6 university hospitals with local, recurrent hepatocellular carcinoma who underwent salvage hepatectomy after their initial radiofrequency ablation treatment. Pathologic characteristics and prognostic factors influencing overall survival were analyzed. Results Noncurative resection, des-gamma carboxy prothrombin levels >40 mAU/mL, and multiple preceding treatments before salvage hepatectomy were negative prognostic factors for overall survival. The 5-year survivals for the prognostic factors were 0%, 24%, and 30%, respectively, after salvage hepatectomy, and 0%, 54%, and 54% after initial radiofrequency ablation treatment, respectively. As for the pathologic finding of local, recurrent hepatocellular carcinoma after radiofrequency ablation, vascular invasion was observed frequently in patients with increases in des-gamma carboxy prothrombin levels and with multiple preceding treatments before salvage hepatectomy with a frequency of 59% and 53%, respectively ( P  
ISSN:0039-6060
1532-7361
DOI:10.1016/j.surg.2016.04.023