Background : Recurrence rate of HCC is 40-70% within five years after curative resection. Repeated hepatectomy(RH) is known to be the best treatment option but, not all patients with recurred HCC are eligible for RH. RFA and TACE can be another treatment options. In this study we aimed to evaluate the outcomes of late recurred intrahepatic HCC after curative resection.

Methods : This study was a single-centered retrospective study. Among 505 patients who underwent liver resection as initial treatment of HCC, late intrahepatic recurred patients were sorted. After that, patients with a few (≤3) and small (≤3cm) recurrence were selected. Prognostic factors related to re-recurrence free survival(RRFS) and overall survival(OS) were analyzed. RRFS and OS were compared between three retreatment groups(RH, TACE, and RFA).

Results : After multivariate analysis, age older than 65 (p < 0.001), no HBV infection (p = 0.020), primary tumor bigger than 50 mm (p = 0.027), and three recurred tumors (p < 0.001) were associated with poor RRFS. But only age older than 65 was significant factor in multivariant analysis in OS. RFA group had better RRFS compared with TACE group. Otherwise, three retreatment groups (RH, TACE, RFA) showed no significant difference in RRFS and OS.

Conclusions : RH is best treatment option for late recurred intrahepatic HCC. But a few are eligible for RH. RFA can be a comparable treatment option to RH when the lesions’ size ≤3 cm and number ≤3. TACE should only be an alternative option in early recurred, multifocal, invasive lesions when LR or RFA are not possible.