The aim of this study is to investigate the patterns of intrahepatic recurrence after curative resection of hepatocellular carcinoma(HCC) and analyze the clinical features of each pattern of intrahepatic recurrence. From 1988, one hundred
fourteen
patients underwent curative hepatic resection for HCC. Among them, 33 patients who had only intrahepatic recurrences were analyzed. The patterns of intrahepatic recurrence were classified as Type I(nodular recurrences with 1-4 nodules) and Type
II(widespread diffuse recurrences), using angiography. Type I was further divided into Type Ia(recurred at ipsilateral lobe), Type Ib(recurred first in ipsilateral, iater contralateral lobe) and Type Ic(recurred at contralateral lobe). Of 33
patients,
20 patients were classified as Type I(Type Ia 16, Type Ib : 2, Type Ic:2) and 13 patients as Type II. There were no significant differences in age, sex, Child classification, presence of liver disease, level of alpha-fetoprotein, size and number
of
primary tumor, amount of transfusion during operation and operation time. However, positive rate of HBsAg was higher in Type II. Mean recurrent time from primary operation was 22.5 months in Type I and 14.7 months in Type II. This difference was
statistically significant. In total 33 patients 1, 2 and 3 year survival rate were 77%, 64% and 48%, respectively. I Type I, 1,2 and 3 year survival rate were 89%, 80% and 80% and in Type II patients, 61%, 46% and 0%, respectively. In summary,
the
time
of recurrence was longer and the prognosis was better in Type I that in Type II. This study suggests that there may be two types of recurrence patterns after curative resection for HCC, which have different pathogenesis and prognosis. (Korean J
Gastroenterol 1994 ; 26 : 669-674)
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