Multidisciplinary therapy after hepatectomy for hepatocellular carcinoma from the view point of tumor recurrence]

This study was performed to elucidate the risk factors of early recurrence after hepatectomy for the 112 patients with hepatocellular carcinoma, excluding absolute non-curative resections and operative deaths, and effects of early prophylactic management were evaluated. In Cox's multivariate analysis, 3 pathological factors of portal vein invasion, intrahepatic metastasis and capsule formation or capsule infiltration as well as the nuclear DNA ploidy pattern were significantly correlated to postoperative recurrence. The patients with 2 or more pathological factors or with DNA aneuploid tumors developed recurrence at early postoperative period. However, even in the DNA aneuploid tumors, the patients with high DNA index and low S-phase fraction showed relatively better prognosis. Argyrophilic proteins of nucleolar organizer regions (AgNOR) were also correlated well to nuclear DNA analysis, showing one of the good indicators for estimating biological malignant nature. Therefore, intra-arterial regional chemolipiodolization therapy should be performed for these high risk patients at early period after hepatectomy. With these managements we have been getting much lower incidence of early recurrence.