Recurrence after Liver Resection for Hepatocellular Carcinoma in Cirrhotic and Noncirrhotic Patients

Introduction: Liver resection is the treatment of choice for hepatocellular carcinoma (HCC) in non-cirrhotic livers, whereas resections in cirrhotic livers remains a subject of controversy. Patients and Methods: Between October 2003 and August 2005 a total of 16 patients were operated for HCC. Patients with (group A, n = 10) or without cirrhosis (group B, n = 6) were compared using parametric and non-parametric tests as indicated. Significance is assumed if p < 0.05. Results: Tumor diameter was 7.44 (1.5-22) cm in group A and 11.25 (4.5-16) cm in group B. All but one patient of group B histologically had tumor-free margins. One patient had to be operated for bile leak (group A), one for bleeding and another one for a leak of the hepaticojejunostomy (both group B). During the observation period of 22.5 months, 1 patient in each group died. Tumor recurrence was seen in 3 patients in each group after 16.2 +/- 2 months. One of them underwent re-operation. Conclusion: Liver resection for HCC is feasible even in cirrhotic livers with a low complication but high tumor recurrence rate. For cirrhotic patients with sufficient liver function, resection represents the only option if the patient does not meet the criteria for transplantation. Moreover, small tumors can be resected to delay transplantation, provided that functional capacity has been properly assessed.