Current status and progress in the surgical treatment of recurrent hepatocellular carcinoma_West China Medical Journal

Authors：

CHEN Yanyu , ZHANG Xiaoyun , LI Chuan ,  WEN Tianfu

Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

WEN Tianfu, Email: wentianfu@scu.edu.cn

Keywords：

Recurrent hepatocellular carcinoma; Hepatectomy; Liver transplantation; Radiofrequency ablation; Transcatheter arterial chemoembolization

DOI：

10.7507/1002-0179.201904043

Video：

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The treatment of liver cancer is still a challenge in the world, and it is mainly refers to hepatocellular carcinoma (HCC). There are many factors affecting the overall survival rate of HCC; the recurrence of HCC is the main risk factor affecting the survival of patients, hence, it is urgent to explore the clinical treatment of recurrent HCC to obtain long-term survival of the patients. Up to now, surgical treatment is a radical treatment for HCC. Similarly, liver resection and liver transplantation are still the main therapy methods for recurrent HCC. In addition, radiofrequency ablation and transcatheter arterial chemoembolization and other local treatments still play an irresistible role. Therefore, emphasizing the postoperative follow-up of patients, diagnosing recurrent HCC in early stage, paying attention to the risk factors of HCC recurrence and selecting a suitable treatment plan for individuals are critical ways to prolong the survival of patients.

Citation： CHEN Yanyu, ZHANG Xiaoyun, LI Chuan, WEN Tianfu. Current status and progress in the surgical treatment of recurrent hepatocellular carcinoma. West China Medical Journal, 2019, 34(6): 688-692. doi: 10.7507/1002-0179.201904043 Copy

1.	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
2.	中華人民共和國國家衛生和計劃生育委員會. 原發性肝癌診療規范(2017年版). 臨床肝膽病雜志, 2017, 33(8): 1419-1431.
3.	Ng IO, Guan XY, Poon RT, et al. Determination of the molecular relationship between multiple tumour nodules in hepatocellular carcinoma differentiates multicentric origin from intrahepatic metastasis. J Pathol, 2003, 199(3): 345-353.
4.	四川大學華西醫院肝癌MDT團隊, 文天夫. 肝細胞癌切除術后復發轉移的防治: 華西醫院多學科專家共識. 中國普外基礎與臨床雜志, 2017, 24(8): 927-939.
5.	Eguchi S, Kanematsu T, Arii S, et al. Comparison of the outcomes between an anatomical subsegmentectomy and a non-anatomical minor hepatectomy for single hepatocellular carcinomas based on a Japanese nationwide survey. Surgery, 2008, 143(4): 469-475.
6.	向邦德, 黎樂群, 趙蔭農, 等. 復發性肝癌再切除術患者預后因素分析. 中國腫瘤臨床, 2010, 37(17): 994-997.
7.	Nobuoka D, Kato Y, Gotohda N, et al. Postoperative serum alpha-fetoprotein level is a useful predictor of recurrence after hepatectomy for hepatocellular carcinoma. Oncol Rep, 2010, 24(2): 521-528.
8.	Liu Y, Wang ZX, Cao Y, et al. Preoperative inflammation-based markers predict early and late recurrence of hepatocellular carcinoma after curative hepatectomy. Hepatobiliary Pancreat Dis Int, 2016, 15(3): 266-274.
9.	Matsuda M, Fujii H, Kono H, et al. Surgical treatment of recurrent hepatocellular carcinoma based on the mode of recurrence: repeat hepatic resection or ablation are good choices for patients with recurrent multicentric cancer. J Hepatobiliary Pancreat Surg, 2001, 8(4): 353-359.
10.	Poon RT, Fan ST, Ng IO, et al. Different risk factors and prognosis for early and late intrahepatic recurrence after resection of hepatocellular carcinoma. Cancer, 2000, 89(3): 500-507.
11.	Kubota K, Makuuchi M, Kusaka K, et al. Measurement of liver volume and hepatic functional reserve as a guide to decision-making in resectional surgery for hepatic tumors. Hepatology, 1997, 26(5): 1176-1181.
12.	Shirabe K, Shimada M, Gion T, et al. Postoperative liver failure after major hepatic resection for hepatocellular carcinoma in the modern era with special reference to remnant liver volume. J Am Coll Surg, 1999, 188(3): 304-309.
13.	Siriwardana RC, Lo CM, Chan SC, et al. Role of portal vein embolization in hepatocellular carcinoma management and its effect on recurrence: a case-control study. World J Surg, 2012, 36(7): 1640-1646.
14.	Lee KT, Wang SN, Su RW, et al. Is wider surgical margin justified for better clinical outcomes in patients with resectable hepatocellular carcinoma?. J Formos Med Assoc, 2012, 111(3): 160-170.
15.	Liu K, Chen Y, Wu X, et al. Laparoscopic liver re-resection is feasible for patients with posthepatectomy hepatocellular carcinoma recurrence: a propensity score matching study. Surg Endosc, 2017, 31(11): 4790-4798.
16.	Yamashita Y, Yoshida Y, Kurihara T, et al. Surgical results for recurrent hepatocellular carcinoma after curative hepatectomy: repeat hepatectomy versus salvage living donor liver transplantation. Liver Transpl, 2015, 21(7): 961-968.
17.	Yong CC, Tsai MC, Lin CC, et al. Comparison of salvage living donor liver transplantation and local regional therapy for recurrent hepatocellular carcinoma. World J Surg, 2016, 40(10): 2472-2480.
18.	Zhang X, Li C, Wen T, et al. Treatment for intrahepatic recurrence after curative resection of hepatocellular carcinoma: salvage liver transplantation or re-resection/radiofrequency ablation? A retrospective cohort study. Int J Surg, 2017, 46: 178-185.
19.	Chan AC, Chan SC, Chok KS, et al. Treatment strategy for recurrent hepatocellular carcinoma: salvage transplantation, repeated resection, or radiofrequency ablation?. Liver Transpl, 2013, 19(4): 411-419.
20.	Hu Z, Zhou J, Li Z, et al. Time interval to recurrence as a predictor of overall survival in salvage liver transplantation for patients with hepatocellular carcinoma associated with hepatitis B virus. Surgery, 2015, 157(2): 239-248.
21.	Kaido T, Mori A, Ogura Y, et al. Living donor liver transplantation for recurrent hepatocellular carcinoma after liver resection. Surgery, 2012, 151(1): 55-60.
22.	Guerrini GP, Gerunda GE, Montalti R, et al. Results of salvage liver transplantation. Liver Int, 2014, 34(6): e96-e104.
23.	張英才, 覃偉, 楊揚. 復發性肝癌行補救性肝移植的療效. 肝膽外科雜志, 2014, 22(2): 87-89.
24.	鄭樹森, 徐驍, 陳峻, 等. 中國肝癌肝移植臨床實踐指南(2018版). 臨床肝膽病雜志, 2019, 35(2): 275-280.
25.	朱繼領, 張克瑞. 射頻消融與再手術治療符合米蘭標準的術后復發性肝癌的Meta分析. 中國普通外科雜志, 2017, 26(7): 838-846.
26.	劉嘉龍, 黃登, 曹利, 等. 腹腔鏡肝切除術和射頻消融術治療復發性肝癌的前瞻性隨機對照研究(中期隨訪分析). 第三軍醫大學學報, 2019, 41(5): 467-472.
27.	步向陽, 陳斌, 李洪, 等. 根治性切除術后復發性小肝癌射頻消融與手術切除的療效比較. 臨床普外科電子雜志, 2014, 2(3): 23-25.
28.	段紀成, 劉凱, 吳孟超, 等. 經皮肝穿刺射頻消融與再次肝切除對復發性小肝癌的隨機對照研究. 肝膽外科雜志, 2015, 23(1): 15-17.
29.	方河清, 唐喆, 何敏志. 射頻消融在復發性肝癌治療中的應用. 肝膽外科雜志, 2012, 20(4): 246-247.
30.	吳飛翔, 王方為, 馬良, 等. 原發性肝癌術后復發246例再治療的近期療效. 中國癌癥防治雜志, 2012, 4(2): 167-170.
31.	Koh PS, Chan AC, Cheung TT, et al. Efficacy of radiofrequency ablation compared with transarterial chemoembolization for the treatment of recurrent hepatocellular carcinoma: a comparative survival analysis. HPB (Oxford), 2016, 18(1): 72-78.
32.	沈鋒, 奚韜. 肝癌切除術后抗復發治療. 中國實用外科雜志, 2008, 28(12): 1029-1031.
33.	Jin YJ, Lee JW, Lee OH, et al. Transarterial chemoembolization versus surgery/radiofrequency ablation for recurrent hepatocellular carcinoma with or without microvascular invasion. J Gastroenterol Hepatol, 2014, 29(5): 1056-1064.
34.	范利斌. 經肝動脈化療栓塞術聯合射頻消融術治療原發性肝癌的臨床療效. 臨床合理用藥雜志, 2016, 9(36): 113-114.
35.	李鵬, 周丁華, 呂偉, 等. TACE聯合高強度聚焦超聲治療中晚期肝癌的臨床研究. 中國現代普通外科進展, 2013, 16(11): 870-874.
36.	水永杰, 魏啟春. 肝臟腫瘤的立體定向放射治療. 實用腫瘤雜志, 2018, 33(2): 107-111.
37.	孟劍, 姜鳳元, 王東艷, 等. 經皮微波固化對肝內大血管旁復發性肝癌的療效及安全性. 現代生物醫學進展, 2016, 16(30): 5974-5976.
38.	Sun HC, Tang ZY, Wang L, et al. Postoperative interferon alpha treatment postponed recurrence and improved overall survival in patients after curative resection of HBV-related hepatocellular carcinoma: a randomized clinical trial. J Cancer Res Clin Oncol, 2006, 132(7): 458-465.
39.	He C, Peng W, Li C, et al. Thymalfasin, a promising adjuvant therapy in small hepatocellular carcinoma after liver resection. Medicine (Baltimore), 2017, 96(16): e6606.

1. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
2. 中華人民共和國國家衛生和計劃生育委員會. 原發性肝癌診療規范(2017年版). 臨床肝膽病雜志, 2017, 33(8): 1419-1431.
3. Ng IO, Guan XY, Poon RT, et al. Determination of the molecular relationship between multiple tumour nodules in hepatocellular carcinoma differentiates multicentric origin from intrahepatic metastasis. J Pathol, 2003, 199(3): 345-353.
4. 四川大學華西醫院肝癌MDT團隊, 文天夫. 肝細胞癌切除術后復發轉移的防治: 華西醫院多學科專家共識. 中國普外基礎與臨床雜志, 2017, 24(8): 927-939.
5. Eguchi S, Kanematsu T, Arii S, et al. Comparison of the outcomes between an anatomical subsegmentectomy and a non-anatomical minor hepatectomy for single hepatocellular carcinomas based on a Japanese nationwide survey. Surgery, 2008, 143(4): 469-475.
6. 向邦德, 黎樂群, 趙蔭農, 等. 復發性肝癌再切除術患者預后因素分析. 中國腫瘤臨床, 2010, 37(17): 994-997.
7. Nobuoka D, Kato Y, Gotohda N, et al. Postoperative serum alpha-fetoprotein level is a useful predictor of recurrence after hepatectomy for hepatocellular carcinoma. Oncol Rep, 2010, 24(2): 521-528.
8. Liu Y, Wang ZX, Cao Y, et al. Preoperative inflammation-based markers predict early and late recurrence of hepatocellular carcinoma after curative hepatectomy. Hepatobiliary Pancreat Dis Int, 2016, 15(3): 266-274.
9. Matsuda M, Fujii H, Kono H, et al. Surgical treatment of recurrent hepatocellular carcinoma based on the mode of recurrence: repeat hepatic resection or ablation are good choices for patients with recurrent multicentric cancer. J Hepatobiliary Pancreat Surg, 2001, 8(4): 353-359.
10. Poon RT, Fan ST, Ng IO, et al. Different risk factors and prognosis for early and late intrahepatic recurrence after resection of hepatocellular carcinoma. Cancer, 2000, 89(3): 500-507.
11. Kubota K, Makuuchi M, Kusaka K, et al. Measurement of liver volume and hepatic functional reserve as a guide to decision-making in resectional surgery for hepatic tumors. Hepatology, 1997, 26(5): 1176-1181.
12. Shirabe K, Shimada M, Gion T, et al. Postoperative liver failure after major hepatic resection for hepatocellular carcinoma in the modern era with special reference to remnant liver volume. J Am Coll Surg, 1999, 188(3): 304-309.
13. Siriwardana RC, Lo CM, Chan SC, et al. Role of portal vein embolization in hepatocellular carcinoma management and its effect on recurrence: a case-control study. World J Surg, 2012, 36(7): 1640-1646.
14. Lee KT, Wang SN, Su RW, et al. Is wider surgical margin justified for better clinical outcomes in patients with resectable hepatocellular carcinoma?. J Formos Med Assoc, 2012, 111(3): 160-170.
15. Liu K, Chen Y, Wu X, et al. Laparoscopic liver re-resection is feasible for patients with posthepatectomy hepatocellular carcinoma recurrence: a propensity score matching study. Surg Endosc, 2017, 31(11): 4790-4798.
16. Yamashita Y, Yoshida Y, Kurihara T, et al. Surgical results for recurrent hepatocellular carcinoma after curative hepatectomy: repeat hepatectomy versus salvage living donor liver transplantation. Liver Transpl, 2015, 21(7): 961-968.
17. Yong CC, Tsai MC, Lin CC, et al. Comparison of salvage living donor liver transplantation and local regional therapy for recurrent hepatocellular carcinoma. World J Surg, 2016, 40(10): 2472-2480.
18. Zhang X, Li C, Wen T, et al. Treatment for intrahepatic recurrence after curative resection of hepatocellular carcinoma: salvage liver transplantation or re-resection/radiofrequency ablation? A retrospective cohort study. Int J Surg, 2017, 46: 178-185.
19. Chan AC, Chan SC, Chok KS, et al. Treatment strategy for recurrent hepatocellular carcinoma: salvage transplantation, repeated resection, or radiofrequency ablation?. Liver Transpl, 2013, 19(4): 411-419.
20. Hu Z, Zhou J, Li Z, et al. Time interval to recurrence as a predictor of overall survival in salvage liver transplantation for patients with hepatocellular carcinoma associated with hepatitis B virus. Surgery, 2015, 157(2): 239-248.
21. Kaido T, Mori A, Ogura Y, et al. Living donor liver transplantation for recurrent hepatocellular carcinoma after liver resection. Surgery, 2012, 151(1): 55-60.
22. Guerrini GP, Gerunda GE, Montalti R, et al. Results of salvage liver transplantation. Liver Int, 2014, 34(6): e96-e104.
23. 張英才, 覃偉, 楊揚. 復發性肝癌行補救性肝移植的療效. 肝膽外科雜志, 2014, 22(2): 87-89.
24. 鄭樹森, 徐驍, 陳峻, 等. 中國肝癌肝移植臨床實踐指南(2018版). 臨床肝膽病雜志, 2019, 35(2): 275-280.
25. 朱繼領, 張克瑞. 射頻消融與再手術治療符合米蘭標準的術后復發性肝癌的Meta分析. 中國普通外科雜志, 2017, 26(7): 838-846.
26. 劉嘉龍, 黃登, 曹利, 等. 腹腔鏡肝切除術和射頻消融術治療復發性肝癌的前瞻性隨機對照研究(中期隨訪分析). 第三軍醫大學學報, 2019, 41(5): 467-472.
27. 步向陽, 陳斌, 李洪, 等. 根治性切除術后復發性小肝癌射頻消融與手術切除的療效比較. 臨床普外科電子雜志, 2014, 2(3): 23-25.
28. 段紀成, 劉凱, 吳孟超, 等. 經皮肝穿刺射頻消融與再次肝切除對復發性小肝癌的隨機對照研究. 肝膽外科雜志, 2015, 23(1): 15-17.
29. 方河清, 唐喆, 何敏志. 射頻消融在復發性肝癌治療中的應用. 肝膽外科雜志, 2012, 20(4): 246-247.
30. 吳飛翔, 王方為, 馬良, 等. 原發性肝癌術后復發246例再治療的近期療效. 中國癌癥防治雜志, 2012, 4(2): 167-170.
31. Koh PS, Chan AC, Cheung TT, et al. Efficacy of radiofrequency ablation compared with transarterial chemoembolization for the treatment of recurrent hepatocellular carcinoma: a comparative survival analysis. HPB (Oxford), 2016, 18(1): 72-78.
32. 沈鋒, 奚韜. 肝癌切除術后抗復發治療. 中國實用外科雜志, 2008, 28(12): 1029-1031.
33. Jin YJ, Lee JW, Lee OH, et al. Transarterial chemoembolization versus surgery/radiofrequency ablation for recurrent hepatocellular carcinoma with or without microvascular invasion. J Gastroenterol Hepatol, 2014, 29(5): 1056-1064.
34. 范利斌. 經肝動脈化療栓塞術聯合射頻消融術治療原發性肝癌的臨床療效. 臨床合理用藥雜志, 2016, 9(36): 113-114.
35. 李鵬, 周丁華, 呂偉, 等. TACE聯合高強度聚焦超聲治療中晚期肝癌的臨床研究. 中國現代普通外科進展, 2013, 16(11): 870-874.
36. 水永杰, 魏啟春. 肝臟腫瘤的立體定向放射治療. 實用腫瘤雜志, 2018, 33(2): 107-111.
37. 孟劍, 姜鳳元, 王東艷, 等. 經皮微波固化對肝內大血管旁復發性肝癌的療效及安全性. 現代生物醫學進展, 2016, 16(30): 5974-5976.
38. Sun HC, Tang ZY, Wang L, et al. Postoperative interferon alpha treatment postponed recurrence and improved overall survival in patients after curative resection of HBV-related hepatocellular carcinoma: a randomized clinical trial. J Cancer Res Clin Oncol, 2006, 132(7): 458-465.
39. He C, Peng W, Li C, et al. Thymalfasin, a promising adjuvant therapy in small hepatocellular carcinoma after liver resection. Medicine (Baltimore), 2017, 96(16): e6606.

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