Comparison of anatomic and non‐anatomic hepatic resection for hepatocellular carcinoma. (19th October 2017)

• Record Type: Journal Article
• Authors: Kaibori, Masaki; Kon, Masanori; Kitawaki, Tomoki; Kawaura, Takayuki; Hasegawa, Kiyoshi; Kokudo, Norihiro; Ariizumi, Shunichi; Beppu, Toru; Ishizu, Hiroyuki; Kubo, Shoji; Kamiyama, Toshiya; Takamura, Hiroyuki; Kobayashi, Tsuyoshi; Kim, Dong‐Sik; Wang, Hee Jung; Kim, Jong Man; Han, Dai Hoon; Park, Sang‐Jae; Kang, Koo Jeong; Hwang, Shin; Roh, Younghoon; You, Young Kyung; Joh, Jae‐Won; Yamamoto, Masakazu
• Is Part Of: Journal of hepato-biliary-pancreatic sciences. Volume 24:Number 11(2017)
• Page Start: 616
• Page End: 626
• Publication Date: 2017-10-19
• Subjects: Anatomic resection -- Hepatocellular carcinoma -- Non‐anatomic resection -- Overall survival; Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 617.556
• DOI: 10.1002/jhbp.502
• Languages: English
• ISSNs: 1868-6974

Abstract

Abstract: Background: The 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). Methods: To 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. Results: Overall 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. Conclusions: Anatomic resection decreases the risk of tumor recurrence and improves OS in patients with a primary, solitary HCC of <5.0 cm in diameter. Abstract : Highlight Kaibori and colleagues compared the post‐hepatectomy outcomes of patients with hepatocellular carcinoma who underwent anatomic resection or non‐anatomic resection using combined data from Japan and Korea. Anatomic resection decreases the risk of tumor recurrence and improves overall survival in patients with a primary, solitary hepatocellular carcinoma <5.0 cm in diameter.