Clinical and radiologic assessments of the results of hepatectomy for small hepatocellular carcinoma and therapeutic arterial embolization for postoperative recurrence

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Abstract
To study the prognostic significance of the state of the residual liver after hepatectomy for small hepatocellular carcinoma (s‐HCC) no larger than 5 cm in diameter, 123 patients were followed for periods from 9 months to 9 years and 1 month. The following results were obtained: (1) recurrence occurred in the residual liver in 58 patients (54.2%) after an average of 14.9 months from hepatectomy; (2) at recurrence diagnosed by imaging, 12 of 48 recurrent patients showed negative alpha‐fetoprotein; (3) computed tomography (CT) had a high sensitivity (71.4%) in detecting recurrence; (4) 5‐year survivals for all patients (n = 123) who had hepatectomy, and for those without recurrence (n = 49) or with recurrence (n = 58) were 19.1%, 48.9%, and 11.0%, respectively; and (5) survivals for the patients who developed recurrence and who did and did not receive embolization treatment (n = 32, 23, respectively) were 70.3% and 37.1% at 1 year, 45.0% and 0% at 3 years, and 14.9% and 0% at 5 years, respectively. It is important to recognize that the patient who has undergone surgery even for s‐HCC should be followed as a super high‐risk patient at regular intervals using CT. Therapeutic embolization for recurrent patients improved the survival after recurrence.