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Langenbeck's Archives of Surgery

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01-08-2017 | ORIGINAL ARTICLE

Treatment and outcomes of recurrent hepatocellular carcinomas

Authors: Gaëtan-Romain Joliat, Pierre Allemann, Ismail Labgaa, Nicolas Demartines, Nermin Halkic

Published in: Langenbeck's Archives of Surgery | Issue 5/2017

Abstract

Purpose

Surgery is one of the best options for curative treatment of hepatocellular carcinomas (HCC). Recurrences are nevertheless common (45–75%). This study aimed to compare overall survival (OS) of patients with recurrent HCC after primary resection to OS of patients without recurrence.

Methods

A retrospective review of all HCC patients operated between 1993 and 2015 was performed. Median and 5-year OS were calculated.

Results

This study included 147 HCC patients. Sixty-seven patients presented a recurrence (46%). Patients with recurrence had a worse prognosis than those without recurrence (median OS 63 vs. 82 months, 5-year OS 47 vs. 54%, p = 0.036). First-line performed treatments were radiofrequency ablation (18, RFA), chemo-embolization (16, TACE), repeat hepatectomy (10), systemic chemotherapy (4), radio-embolization (1), and alcoholization (1). Palliative care was performed in 17 patients. Median OS of patients treated by RFA, TACE, or repeat hepatectomy were similar (77, 71, and 84 months, p = 0.735). Patients treated with chemotherapy/palliative care had lower median OS compared to interventional treatments (20 vs. 77 months, p < 0.0001).

Conclusions

Recurrence after surgical HCC resection is frequent and negatively impacts OS. Interventional treatments of recurrences offered improved outcomes compared to medical care. In selected patients, RFA, TACE, and repeat hepatectomy allowed similar OS as non-recurrent cases.

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Title: Treatment and outcomes of recurrent hepatocellular carcinomas
Authors: Gaëtan-Romain Joliat
Pierre Allemann
Ismail Labgaa
Nicolas Demartines
Nermin Halkic
Publication date: 01-08-2017
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 5/2017
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-017-1582-9

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Springer Medicine

Treatment and outcomes of recurrent hepatocellular carcinomas

Abstract

Purpose

Methods

Results

Conclusions

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Abstract

Purpose

Methods

Results

Conclusions

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