Poor prognostic factors after repeat hepatectomy for recurrent hepatocellular carcinoma in the modern era

Eiji Tsujita, Yo Ichi Yamashita, Kazuki Takeishi, Ayumi Matsuyama, Shin Ichi Tsutsui, Hiroyuki Matsuda, Takeo Toshima, Akinobu Taketomi, Ken Shirabe, Teruyoshi Ishida, Yoshihiko Maehara

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19 Citations (Scopus)


The purpose of this study was to determine the poor prognostic factors after repeat hepatectomy (Hx) in patients with recurrent hepatocellular carcinoma (HCC). Overall survival rates and clinicopathological variables in 112 patients with repeat Hx from 1992 to 2010 were compared with those in 531 patients who underwent a primary Hx. To clarify the poor prognosis factors after repeat Hx, survival data among 112 patients were univariately and multivariately analyzed. Overall survival after repeat Hx was similar for that of the patients who underwent a primary Hx. The mean age of repeat Hx group was significantly higher, and a well-preserved liver function was recognized than the primary Hx group. Multivariate analysis revealed that: 1) indocyanine green retention rate at 15 minutes; 2) disease-free interval; 3) tumor size; 4) portal vein invasion at primary Hx; 5) gender; and 6) estimated blood loss to be an independent and significant poor prognostic factors. The overall 3-year postrecurrence overall survival rates were 100, 91.3, 59.6, and 0 per cent at risk number (R) R0, R1/2, R3, R4, respectively (P<0.05). Repeat Hx provided a good compatible prognosis with primary Hx. In our findings, five risk factors to predict poor outcomes after repeat Hx were useful. Patients with recurrent HCC do not have universally poor outcomes, and our simple scoring system using five poor prognostic factors could serve to advise the prognosis and the potential benefit for patient selection about repeat Hx.

Original languageEnglish
Pages (from-to)419-425
Number of pages7
JournalAmerican Surgeon
Issue number4
Publication statusPublished - Apr 2012
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery


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