Comparison of anatomic and non-anatomic hepatic resection for hepatocellular carcinoma

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 HwangYounghoon Roh, Young Kyung You, Jae Won Joh, Masakazu Yamamoto

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22 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)616-626
Number of pages11
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume24
Issue number11
DOIs
Publication statusPublished - 2017 Nov

Keywords

  • Anatomic resection
  • Hepatocellular carcinoma
  • Non-anatomic resection
  • Overall survival

ASJC Scopus subject areas

  • Medicine(all)

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    Kaibori, M., Kon, M., Kitawaki, T., Kawaura, T., Hasegawa, K., Kokudo, N., Ariizumi, S., Beppu, T., Ishizu, H., Kubo, S., Kamiyama, T., Takamura, H., Kobayashi, T., Kim, D. S., Wang, H. J., Kim, J. M., Han, D. H., Park, S. J., Kang, K. J., ... Yamamoto, M. (2017). Comparison of anatomic and non-anatomic hepatic resection for hepatocellular carcinoma. Journal of Hepato-Biliary-Pancreatic Sciences, 24(11), 616-626. https://doi.org/10.1002/jhbp.502