Sequential multidisciplinary treatment of hepatocellular carcinoma: The role of surgery as rescue therapy for failure of percutaneous ablation therapies

✍ Scribed by Nazario Portolani; Gian Luca Baiocchi; Arianna Coniglio; Luigi Grazioli; Eleonora Frassi; Federico Gheza; Stefano Maria Giulini

• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 103 KB
• Volume: 100
• Category: Article
• ISSN: 0022-4790
• DOI: 10.1002/jso.21375

✦ Synopsis

Abstract

Background and Objectives

The recurrence of hepatocellular carcinoma (HCC) after percutaneous ablation is poorly evaluated.

Methods

Thirty‐six cases of recurrence after percutaneous ablation (PA) (Group 1) are compared to those after surgery, treated with re‐resection (26 patients, Group 2) and PA (31 patients, Group 3).

Results

Recurrence was usually local after PA and distant after resection. Compared to Groups 2 and 3, local recurrences after PA were larger (4.2 vs. 2.3 cm) and more often invasive (43% vs. 10%). No different clinical/pathological aspects were noted in distant recurrences among the groups. After treatment the survival rate (1, 2, 3 and 5 years) was no different between the groups; in an intention‐to‐treat analysis of survival for local recurrences, survival was significantly lower in Group 1 (78%, 78%, 67% and 28%) than in Groups 2 and 3 (100%, 88%, 75% and 45%) (P < 0.05).

Conclusions

PA and surgery can be sequentially employed for HCC. The type of primary treatment does not influence the features of distant liver recurrence, while local recurrence after PA often requires more extensive liver resection. J. Surg. Oncol. 2009;100:580–584. © 2009 Wiley‐Liss, Inc.