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Comparison of anatomic and non‐anatomic hepatic resection for hepatocellular carcinoma |
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| Authors: | Masaki Kaibori Masanori Kon Tomoki Kitawaki Takayuki Kawaura Kiyoshi Hasegawa Norihiro Kokudo Shunichi Ariizumi Toru Beppu Hiroyuki Ishizu Shoji Kubo Toshiya Kamiyama Hiroyuki Takamura Tsuyoshi Kobayashi Dong‐Sik Kim Hee Jung Wang Jong Man Kim Dai Hoon Han Sang‐Jae Park Koo Jeong Kang Shin Hwang Younghoon Roh Young Kyung You Jae‐Won Joh Masakazu Yamamoto |
| Affiliation: | 1. Department of Surgery, Kansai Medical University, Osaka, Japan;2. Department of Mathematics, Kansai Medical University, Osaka, Japan;3. Hepato‐Biliary‐Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;4. Department of Surgery, Tokyo Women's Medical University, Tokyo, Japan;5. Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan;6. Department of Surgery, Sapporo Kosei Hospital, Sapporo, Japan;7. Department of Hepato‐Biliary‐Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan;8. Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan;9. Department of Gastroenterological Surgery, Kanazawa University, Ishikawa, Japan;10. Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;11. Department of Surgery, Korea University College of Medicine, Seoul, Korea;12. Department of Surgery, Ajou University School of Medicine, Suwon, Korea;13. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea;14. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea;15. Center for Liver Cancer, National Cancer Center, Goyang, Korea;16. Department of Surgery, Keimyung University Dongsan Medical Center, Daegu, Korea;17. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;18. Department of Surgery, Dong‐A University College of Medicine, Busan, Korea;19. Department of Surgery, The Catholic University of Korea, Seoul, Korea |
| Abstract: | BackgroundThe aim of the present study was to compare the prognostic impact of anatomic resection (AR) versus non‐anatomic resection (NAR) on patient survival after resection of a single hepatocellular carcinoma (HCC).MethodsTo control for confounding variable distributions, a 1‐to‐1 propensity score match was applied to compare the outcomes of AR and NAR. Among 710 patients with a primary, solitary HCC of <5.0 cm in diameter that was resectable by either AR or NAR from 2003 to 2007 in Japan and Korea, 355 patients underwent NAR and 355 underwent AR of at least one section with complete removal of the portal territory containing the tumor.ResultsOverall survival (OS) was better in the AR than NAR group (hazard ratio 1.67, 95% confidence interval 1.28–2.19, P < 0.001) while disease‐free survival showed no significant difference. Significantly fewer patients in the AR than NAR group developed intrahepatic HCC recurrence and multiple intrahepatic recurrences. Patients with poorly differentiated HCC who underwent AR had improved disease‐free survival and OS.ConclusionsAnatomic resection decreases the risk of tumor recurrence and improves OS in patients with a primary, solitary HCC of <5.0 cm in diameter. |
| Keywords: | Anatomic resection Hepatocellular carcinoma Non‐anatomic resection Overall survival |