Value and reasonable choice of reoperation for recurrence of hepatocellular carcinoma after operation / 中国实用外科杂志

ABSTRACT

For recurrent hepatocellular carcinoma(HCC),hepatectomy is an active and active treatment method.Choosing appropriate cases will get good results. RecurrentHCC complies with Milan criteria,ECOG score is 0-2,andsalvage liver transplantation(SLT) can be considered. If thediameter of the tumor is less than 5 cm,single or multiplelesions are concentrated in a certain area,located at the edgeof the liver,and the liver function is good,hepatectomy should be the first choice. Laparoscopic surgery may also beconsidered in units with good equipment and accumulatedexperience. For recurrent HCC with tumor diameter > 5 cm,aslong as liver reserve function is allowed and FRLV issufficient,it should be actively strived for resection again. If ithas been proved that recurrent HCC originated from a singlecenter or combined with MVI,comprehensive treatment shouldbe rationally arranged. Besides hepatectomy,RFA,TACE,TACE + RFA and targeted drugs should be sequentiallycombined. Otherwise,the effect of hepatectomy alone is notideal. If recurrent HCC is accompanied by decompensation ofliver function,severe cirrhosis,portal hypertension,andinvasion of the main intrahepatic vascular trunk,it isrecommended to abandon reoperation and adopt other non-surgical treatment.