Adjuvant therapy after surgical resection of hepatocellular carcinoma (HCC) should be tried based on the prediction of intrahepatic recurrence pattern. The purpose of this study was to identify patients with intrahepatic recurrence due to the residual intrahepatic metastatic foci (Rec: im) or multicentric carcinogenesis (Rec; mc) and to evaluate the effectiveness of combination therapy with an anticancer drug and interferon α (IFNα). The disease-free survival curve was obtained by the Kaplan-Meier method in 294 patients with resectable HCC. The regression line (Y = - aX+b) was drawn by SAS LIFE TEST PROCEDURE in the early (Y1; within two years: Rec : im+Rec : mc) and late (Y2 ;4 years later : Rec: mc) periods and the incidence of Rec: im (b1-b2) was determined. The incidence of Rec: im in stage 1 was 40% in relative curative cases, and in stage 2 were 22% and 42% in relative curative and relative noncurative cases, respectively. In stage 3 and 4, all patients but one had recurrence within 4 years. Tumor marker levels were markedly decreased in 4 of 5 patients following the combination therapy of anticancer drug and IFNα. In conclusion, Rec: im was frequent, and therefore, adjuvant therapy was indicated in patients with stage 1 (relative curative), stage 2 (relative noncurative), stage 3 and stage 4. A combination of chemotherapy and systemic IFNα administration may be a promising postoperative adjuvant therapy.
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