World Journal of Surgery

, Volume 32, Issue 4, pp 632–638

Second Hepatic Resection for Recurrent Hepatocellular Carcinoma in Patients with Chronic Hepatitis C

  • Shoji Kubo
  • Shigekazu Takemura
  • Takahiro Uenishi
  • Takatsugu Yamamoto
  • Kazuki Ohba
  • Masao Ogawa
  • Seikan Hai
  • Tsuyoshi Ichikawa
  • Shintaro Kodai
  • Hiroji Shinkawa
  • Hiromu Tanaka
Article

DOI: 10.1007/s00268-007-9365-z

Cite this article as:
Kubo, S., Takemura, S., Uenishi, T. et al. World J Surg (2008) 32: 632. doi:10.1007/s00268-007-9365-z

Abstract

Background

Although a second hepatic resection (SHR) for recurrent hepatocellular carcinoma (HCC) is widely accepted, the indications for SHR have not been established. The risk factors for HCC recurrence after SHR were evaluated to investigate the indications for SHR.

Methods

Subjects included 51 patients who underwent a second hepatic resection for recurrence of HCV-related HCC. Sixteen patients received interferon therapy before or after the first operation. Six patients attained a sustained viral response (SVR) that was defined as return of the alanine aminotransferase (ALT) activity to within the reference range and no detectable serum HCV RNA for at least 1 year after interferon therapy. A biochemical response (BR), defined as a normalized ALT activity for at least 1 year after interferon therapy with or without the transient disappearance of serum HCV RNA, was attained in three patients. The other seven patients were defined as the nonresponse (NR) group.

Results

By univariate analysis, NR and lack of interferon therapy, high indocyanine green retention rate at 15 min (ICGR15), high aspartate aminotransferase activity, high ALT activity, large tumor, and multiple tumors were risk factors for HCC recurrence after SHR. By multivariate analysis, NR and lack of interferon therapy, high ICGR15, large tumor, and multiple tumors were independent risk factors.

Conclusions

Patients in whom active hepatitis has been controlled by interferon therapy are the best candidates for SHR. Interferon therapy should be recommended in patients undergoing resection of an HCV-related HCC because SHR can prolong life in SVR and BR patients.

Copyright information

© Société Internationale de Chirurgie 2008

Authors and Affiliations

  • Shoji Kubo
    • 1
  • Shigekazu Takemura
    • 1
  • Takahiro Uenishi
    • 1
  • Takatsugu Yamamoto
    • 1
  • Kazuki Ohba
    • 1
  • Masao Ogawa
    • 1
  • Seikan Hai
    • 1
  • Tsuyoshi Ichikawa
    • 1
  • Shintaro Kodai
    • 1
  • Hiroji Shinkawa
    • 1
  • Hiromu Tanaka
    • 1
  1. 1.Department of Hepato-Biliary-Pancreatic SurgeryOsaka City University Graduate School of MedicineAbeno-kuJapan

Personalised recommendations