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Journal of the Korean Liver Cancer Study 2009;9(1):41-44.
Published online June 30, 2009.
A Case of Early Recurred Hepatocellular Carcinoma with Initial Expectation of Good outcome by Surgical Resection
Jung Min Lee1,5, Jun Yong Park1,5, Do Young Kim1,5, Kyung Sik Kim2,5, Young Nyun Park3,5, Myeong-Jin Kim4,5, Chae Yoon Chon1,5, Kwang-Hyub Han1,5
1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
2Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
3Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
4Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
5Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Correspondence:  Kwang-Hyub Han,
Email: gihankhys@yuhs.ac
Copyright ©2009 by The Korean Liver Cancer Association
Abstract
Hepatocellular carcinoma (HCC) is one of the cancers with poor prognosis as HCC develops on base of cirrhosis in majority cases, which requires multidisciplinary approach. If feasible, however, surgical resection is the choice of treatment, and many previous studies and guidelines offered appropriate indications for surgical resection; firstly, preservation of liver function should be confirmed with traditional Child-Pugh classification or more recently with Indocyanine Green retention test or absence of portal hypertension. Secondly, several variables about the size, number, and vascular invasion of tumor should be taken into consideration. It is suggested that to lessen the risk of recurrence gross vascular invasion be absent and the number of tumor be single. Regarding the size of tumor, although risk of dissemination increases with size, some tumors may grow as a single mass and thus the size of tumor is not a clear-cut limiting factor. Based on above suggestions, we herein offer our experience of a patient with initial hopeful expectation of good outcome with surgical resection, but who eventually turned out to result in disseminated tumor recurrence. Further study, maybe regarding a combination of adjuvant or neoadjuvant transarterial chemoembolization/chemotherapy or radiotherapy, is necessary on how to manage such patient.
Key Words: Hepatocellular carcinoma; Hepatic lobectomy; Recurrence
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