• Yusuke Yamamoto, Hisashi Ikoma, Ryo Morimura, Hirotaka Konishi, Yasutoshi Murayama, Shuhei Komatsu, Atsushi Shiozaki, Yoshiaki Kuriu, Takeshi Kubota, Masayoshi Nakanishi, Daisuke Ichikawa, Hitoshi Fujiwara, Kazuma Okamoto, Chouhei Sakakura, Toshiya Ochiai, and Eigo Otsuji.
• Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku Kyoto 6028566, Japan. ikoma@koto.kpu-m.ac.jp.
• Anticancer Res. 2013 Nov 1; 33 (11): 5097-105.

BackgroundThe aim of this study was to characterize changes in outcome following hepatectomy for hepatocellular carcinoma (HCC) over a 30-year period.Patients And MethodsThe clinical records of 372 patients who underwent a macroscopic curative hepatectomy for treatment of HCC between 1980 and 2009 were retrospectively examined. Patients were divided into two groups: an early group (1980-2000) and a late group (2001-2009). The relationship between the chronological treatment period and the surgical outcomes was investigated.ResultsThe disease-free survival (DFS) was comparable between the early and late groups (at 5 years: 30.3% vs. 31.2%, p=0.526), however, the overall survival (OS) of the late group was significantly better than the one of the early group (at 5 years: 80.1% vs. 50.4%, p<0.001), with this being an independent prognostic factor. Among the 148 patients who underwent transarterial chemoembolization (TACE) for initial hepatic recurrence, the OS after initial recurrence of the late group was significantly better than that of the early group (p=0.002). The OS after initial recurrence was significantly better in patients who underwent repeat hepatectomy than in those who underwent TACE (p=0.044).ConclusionThe results of hepatectomy for HCC have improved over time by use of various combination therapies after initial HCC recurrence. A repeat hepatectomy may be an acceptable treatment option for HCC recurrence in selected patients.

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