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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jul 8, 2015; 7(13): 1755-1760
Published online Jul 8, 2015. doi: 10.4254/wjh.v7.i13.1755
Surgical treatment of intra hepatic recurrence of hepatocellular carcinoma
Laurence Lacaze, Michel Scotté
Laurence Lacaze, Digestive Surgery Department, Grenoble University Hospital, Albert Michallon, 38000 Grenoble, France
Michel Scotté, Digestive Surgery Department, Rouen University Hospital, Charles Nicolle, 76000 Rouen, France
Author contributions: Lacaze L and Scotté M wrote the paper.
Conflict-of-interest statement: The authors have no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Michel Scotté, MD, PhD, Digestive Surgery Department, Rouen University Hospital, Charles Nicolle, 1 rue de Germont, 76000 Rouen, France. michel.scotte@chu-rouen.fr
Telephone: +33-2-32880126 Fax: +33-2-32888416
Received: December 31, 2014
Peer-review started: January 1, 2015
First decision: January 20, 2015
Revised: May 14, 2015
Accepted: June 18, 2015
Article in press: June 19, 2015
Published online: July 8, 2015
Processing time: 191 Days and 13 Hours
Abstract

Recurrence after hepatocellular carcinoma (HCC) is frequent. Currently, there are no recommendations on therapeutic strategy after recurrence of HCC. Whereas the 5 year-recurrence rate after resection of HCC is 100%, this drops to 15% after primary liver transplantation. Repeat hepatectomy and salvage liver transplantation (SLT) could be performed in selected patients to treat recurrent HCC and enable prolonged overall survival after treatment of recurrence. Other therapies such as local ablation, chemoembolization or sorafenib could be proposed to those patients unable to benefit from resection or SLT. A clear definition of the place of SLT and “prophylactic” liver transplantation is required. Indeed, identifying risks factors for recurrence at time of primary liver resection of HCC may help to avoid recurrence beyond Milan criteria and non-resectable situations. In this review, we summarize the recent data available in the literature on the feasibility and outcomes of repeat hepatectomy and SLT as treatment for recurrent HCC.

Keywords: Hepatocellular carcinoma; Liver resection; Survival; Intrahepatic recurrence; Liver transplantation

Core tip: Recurrence after hepatocellular carcinoma (HCC) is frequent. Repeat hepatectomy and salvage liver transplantation (SLT) could be performed in selected patients to treat recurrent HCC and enable prolonged overall survival after treatment of recurrence. A clear definition of the place of SLT and “prophylactic” liver transplantation is required. Identifying risks factors for recurrence at time of primary liver resection of HCC may help to avoid recurrence beyond Milan criteria and non-resectable situations. In this review, we summarize the recent data available in the literature on the feasibility and outcomes of repeat hepatectomy and SLT as treatment for recurrent HCC.