Of 270 consecutive patients with hepatocellular carcinoma who underwent surgery, 60 who had recurrence and were subsequently treated with transcatheter arterial embolization were analyzed. The longest interval between surgery and recurrence in the 60 patients who underwent transcatheter arterial embolization was 7 yr. Recurrence was initially found in the remnant liver in all patients but one; extrahepatic metastases were detected in 13 patients (26%) during follow-up. A "multiple" type was the most common (64%) hepatic recurrence pattern on angiography, followed by the "solitary" (16%) and "tumor thrombus" (12%) patterns. Hepatic recurrence was most frequently found in the ipsilateral lobe (48%) relative to the site of the primary hepatocellular carcinoma. Multivariate analysis of the factors affecting survival after transcatheter arterial embolization indicated that recurrence pattern (p = 0.026) and distant metastases (p = 0.011) were significant. Of 13 patients with distant metastases, 11 had the "multiple" pattern of hepatic recurrence. Survival rates for all 60 patients after initial surgery and after transcatheter arterial embolization were 90% and 64%, respectively, at 1 yr; 62% and 24%, respectively, at 3 yr; and 27% and 6%, respectively, at 6 yr. On analysis of survival rates after transcatheter arterial embolization in 37 patients with recurrence only in the liver and of the response of recurrent hepatocellular carcinoma to transcatheter arterial embolization, a sig-nifβ¬cant difference was noted between those with "partial response" and "progressive disease" (p < 0.06) and between those with "no change" and "progressive disease" (p < 0.06). (HEPATOLOGY 1992;16906-
911.)
Even though resection of HCC has become relatively easy and safe with improved surgical techniques (11,