368 SURGICAL RESECTION VERSUS LAPAROSCOPIC RADIOFREQUENCY ABLATION FOR TREATMENT OF HEPATOCELLULAR CARCINOMA IN CHILD A PATIENTS: A COMPARATIVE STUDY

Background and Aims:In postoperative recurrent hepatocellular carcinoma (HCC), 1 and 3 year overall survival rates after re-resection or radiofrequency ablation (RFA) is reported to be 93.9-89.0%and 65.7-46.0%,respectively.Transarterial chemoembolization (TACE) is known to be an effective modality for palliative treatment of HCC.The aim of this study is to evaluate the efficacy and safety of TACE for recurrent HCC after curative resection and to find factors affecting prognosis.Methods: From January 1995 to July 2006, among 169 patients who experienced recurred HCC after curative resection, 114 patients underwent TACE as the first-line therapy and have been followed until July 2007.Results: The mean age was 55.0±9.1 years with 91 (79.8%) patients male.The most common etiology of HCC was hepatitis B virus infection in 95 (83.3%) patients.At the time of resection, mean tumor size was 4.8±2.9cm, and 96 (84.2%) patients had single tumor.Recurrence of HCC occurred within 6 months after resection in 40 (35.1%)patients.Single nodular recurrence was observed in 53 (46.5%) patients.The mean size of recurred HCC was 2.1±1.2cm.The disease free survival following TACE was 26.2% at 1 year, 9.5% at 2 year, and 7.6% at 3 year, respectively.Overall survival after TACE was 77.8% at 1 year, 53.6% at 3 year, and 31.6% at 5 year, respectively.In 21 (18.4%)patients, serum aminotransferase and/or bilirubin was elevated after TACE, but immediately normalized after conservative treatment.Fever unrelated infection, nausea, and epigastric pain developed in 9 (7.9%), 3 (2.6%), and 1 (0.9%) patient, respectively.One patient died of biliary sepsis after TACE.Cox regression analysis revealed that resected tumor size (>5cm), time to recurrence (>6 month), and TNM stage independently affected disease free survival (P < 0.05).The time to recurrence (>6 month) and TNM stage were found to be associated with overall survival (P < 0.05).Conclusions: TACE might be an efficient and safe treatment modality for recurrent HCC after curative resection.