Liver/PancreasOutcome of salvage hepatic resection for recurrent hepatocellular carcinoma after radiofrequency ablation therapy
Section snippets
Patients
Between September 2002 and December 2011, 974 hepatic resections were performed for HCC at our institution. Among them, salvage resection was performed for intrahepatic, recurrent HCC after RFA in 46 consecutive patients. The RFA was not performed by a surgeon but by a gastroenterological physician at our institution or at another local institution using a percutaneous, transhepatic approach guided by ultrasonography. These patients comprised the study population (Salvage group) and were
Patient characteristics (Table I)
As for the treatments performed before salvage resection, 32 of the 46 patients (70%) had undergone transcatheter arterial chemoembolization treatment at least once. Between the recurrence after RFA and the salvage resection, selective transcatheter arterial chemoembolization was performed in 11 patients as a preoperative treatment in an attempt to decrease tumor thrombi. As for the tumor status before RFA, the median tumor number was 1 (range, 1–3), and the median tumor size was 26 mm (range,
Discussion
Although salvage resection for recurrent HCC after RFA has been sporadically reported,7, 11, 14, 19, 20 few reports have summarized the short-term and long-term outcomes. Our findings suggested that salvage resection for recurrent HCC after RFA was technically demanding when performed according to an adjacent organ-preserving policy; as a result, the operative plan needed to be changed based on the intraoperative findings in 83% of the procedures, mainly because of extensive adhesions to the
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Cited by (28)
Focused Ultrasound-Augmented Cancer Phototheranostics Using Albumin–Indocyanine Green Nanoparticles
2021, Ultrasound in Medicine and BiologyOncologic superiority of anatomic resection of hepatocellular carcinoma by ultrasound-guided compression of the portal tributaries compared with nonanatomic resection: An analysis of patients matched for tumor characteristics and liver function
2018, Surgery (United States)Citation Excerpt :In addition, the NAR group had a greater incidence of multinodular recurrence. Similar data have been previously reported by Shindon et al.11 Of note, a similar aggressive behavior has been reported for the local failure of nonoperative treatments.47,48 The lesser local disease control and the more aggressive disease presentation at recurrence in the NAR group could have some relevance in explaining the worse prognosis.
Salvage hepatectomy for local recurrence of hepatocellular carcinomas offers survival comparable to that of matched patients who undergo primary hepatectomies
2017, European Journal of Surgical OncologyCitation Excerpt :Salvage hepatectomy for HCCs was first proposed by Sitzmann et al. to treat downstaged, initially unresectable tumors.26 As RFA has become more common as a loco-regional treatment, data on outcomes of SH or local recurrence after RFA have become widely available.16–20 In these studies, survival after SH for local recurrence after RFA or PEI was compared with those after repeat or primary hepatectomy, or repeat RFA; most showed comparable OS, except in Yamashita et al.'s study, which showed poorer RFS and OS in patients with SH than in those who underwent second hepatectomies for recurrent HCCs.19
Parenchymal-sparing hepatectomy for deep-placed colorectal liver metastases
2016, Surgery (United States)Survival outcome of salvage hepatectomy in patients with local, recurrent hepatocellular carcinoma who underwent radiofrequency ablation as their first treatment
2016, Surgery (United States)Citation Excerpt :In addition, these factors were related to microscopic vascular invasion. Previous studies showed that the 5-year survival after salvage hepatectomy ranged from 52.3–67%.17,18 In contrast, participants with these risk factors had an unfavorable prognosis, and their 5-year survival rates after salvage hepatectomy were 0% in patients with noncurative resection, 24% in patients with DCP >40mAU/mL, and 30% in patients with multiple preceding treatments.