Introduction : The long-term survival outcome of hepatocellular carcinoma (HCC) is unsatisfactory due to high recurrence rate. And majority of cases showed solitary intra hepatic recurrence. However, there is not an established treatment guideline for the recurrence. This study aimed to determine the survival benefit of treatment strategies according to Barcelona Clinic Liver Cancer stage (BCLC), especially in the patient with BCLC O at recurrence stage (reBCLC-O)

Methods : Study included patients with recurrence after primary hepatic resection at two centers in Korea, between 2005 and 2011. Among the patients, reBCLC-O who is defined as asymptomatic, single and less than 2cm sized in diameter intrahepatic HCC were selected. Survival outcomes of propensity score-matched groups were compared according to treatment modality (Curative and non-curative treatment).

Results : In 917 patients, 394 patients of reBCLC-O were selected. Among these, 150 underwent curative treatment and 203 had non-curative treatment. After propensity score matching, the two groups were well balanced (94 patients in each group). The 1-,3 and 5-year overall survival rates in the curative treatment group were 94,73 and 63 per cent, compared with 86,66 and 58 per cent in non-curative treatment group (P = 0.236). In multivariable analysis, tumor size, number of tumor and albumin level at recurrence stage were independent predictors of worse overall survival.

Conclusions : Non-curative treatment (chemoembolization) can be an alternative treatment option associated favorable overall survival for the patients of reBCLC-O when curative treatment is not feasible.