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World J Gastroenterol. Oct 7, 2013; 19(37): 6127-6130
Published online Oct 7, 2013. doi: 10.3748/wjg.v19.i37.6127
Strategy for improving survival and reducing recurrence of HCV-related hepatocellular carcinoma
Toru Ishikawa
Toru Ishikawa, Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Niigata 950-1104, Japan
Author contributions: Ishikawa T collected the materials and wrote the manuscript.
Correspondence to: Toru Ishikawa, MD, PhD, Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, 280-7 Teraji, Niigata 950-1104, Japan. toruishi@ngt.saiseikai.or.jp
Telephone: +81-25-2336161 Fax: +81-25-2338880
Received: June 2, 2013
Revised: August 2, 2013
Accepted: August 8, 2013
Published online: October 7, 2013

Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third leading cause of cancer-related death in the world. With advances in imaging diagnostics, accompanied by better understanding of high-risk patients, HCC is now frequently detected at an early stage; however, the prognosis remains poor. The recurrence rate after treatment of HCC is higher than that associated with cancers of other organs. This may be because of the high incidence of intrahepatic distant recurrence and multicentric recurrence, especially with hepatitis C virus (HCV)-related hepatocellular carcinoma. The Barcelona Clinic Liver Cancer (BCLC) classification has recently emerged as the standard classification system for the clinical management of patients with HCC. According to the BCLC staging system, curative therapies (resection, transplantation, transcatheter arterial chemoembolization, percutaneous ethanol injection therapy, percutaneous microwave coagulation therapy and percutaneous radiofrequency ablation) can improve survival in HCC patients diagnosed at an early stage and offer a potential long-term cure. However, treatment strategies for recurrent disease are not mentioned in the BCLC classsification. The strategy for recurrence may differ according to the recurrence pattern, i.e., intrahepatic distant recurrence vs multicentric recurrence. In this article, we review recurrent HCC and the therapeutic strategies for reducing recurrent HCC, especially HCV-related HCC.

Keywords: Hepatocellular carcinoma, Intrahepatic distant recurrence, Multicentric recurrence, Hepatitis C virus, Interferon, Arterial chemotherapy

Core tip: Recent advances in treatment modalities have improved the survival rate of patients with hepatocellular carcinoma (HCC). However, long-term outcomes of patients with HCC remain unsatisfactory because of the high incidence of distant intrahepatic recurrence, multicentric recurrence and low survival rates. In particular, hepatitis C virus-related hepatocellular carcinoma has a much higher recurrence rate than other cancers. In this article, we describe the prognosis of recurrent HCC and the therapeutic strategies for reducing recurrent HCC.