Comparison of survival outcomes after anatomical resection and non-anatomical resection in patients with hepatocellular carcinoma

BACKGROUNDS/AIMS: Liver resection is a curative procedure performed worldwide for hepatocellular carcinoma (HCC). Deciding on the appropriate resection range for postoperative hepatic function preservation is an important surgical consideration. This study compares survival outcomes of HCC patients who underwent anatomical or non-anatomical resection, to determine which offers the best clinical survival benefit. METHODS: One hundred and thirty-one patients underwent liver resection with HCC, between January 2007 and February 2015, and were divided into two groups: those who underwent anatomical liver resection (n=88) and those who underwent non-anatomical liver resection (n=43). Kaplan-Meier survival analysis and Cox regressions were used to compare the disease-free survival (DFS) and overall survival (OS) rates between the groups. RESULTS: The mean follow-up periods were 27 and 40 months in the anatomical and non-anatomical groups, respectively (p=0.229). The 3- and 5-year DFS rates were 70% and 60% in the anatomical group and 62% and 48% in the non-anatomical group, respectively. The 3 and 5-year OS rates were 94% and 78% in the anatomical group, and 86% and 80% in the non-anatomical group, respectively. The anatomical group tended to show better outcomes, but the findings were not significant. However, a relative risk of OS between the anatomical and non-anatomical group was 0.234 (95% CI, 0.061-0.896; p=0.034), which is statistically significant. CONCLUSIONS: Although statistical significance was not detected in survival curves, anatomical resection showed better results. In this respect, anatomical resection is more likely to perform in HCC patients with preserve liver function than non-anatomical resection.

The Prognostic Significance of Anatomical Resection for Small Hepatocellular Carcinoma

PURPOSE: There has been controversy concerning which is the best treatment method for small hepatocellular carcinoma between anatomical resection (AR) and non-anatomical resection (NAR). In this retrospective study, we investigated the outcomes of surgical resection for small hepatocellular carcinoma and the clinical results depending on the type of hepatectomy. METHODS: We performed an analysis of the clinicopathologic factors of forty eight patients who underwent hepatectomy for a small (<2 cm) hepatocellular carcinoma between 1990 and 2005. The AR was defined as the resection based on the segment or lobe, as proposed by Couinaud. NAR was defined as the resection of a lesion without regard to the segmental or lobar anatomy, as proposed by Couinaud. The patients were divided into 2 groups base on the hepatectomy procedure: AR (n=24) and NAR (n=24). RESULTS: There were no significant difference between the two groups for the general characteristics of the patients and the clinicopathologic findings, except for ICG R15. The mean ICG R15 in the AR and NAR groups was 11.8+/-6.9 and 22.4+/-15.6, respectively, The NAR group had significantly higher ICG R15 values. The cumulative 1, 3 and 5 year overall survival rates in the AR and NAR groups were 95.8%, 68.2% and 61.3%, and 76.6%, 59.0% and 52.5%, respectively. The cumulative overall survival rate and the mean 5 year disease free survival rate in the AR group (69.8%) were higher than those of the NAR group (45.8%). However, there was no statistically significant difference. CONCLUSION: Depending on the surgical results of this study, there was no statistically significant difference in the outcomes between the AR and NAR groups.

The Prognostic Significance of Anatomical Resection for Small Hepatocellular Carcinoma

PURPOSE: There has been controversy concerning which is the best treatment method for small hepatocellular carcinoma between anatomical resection (AR) and non-anatomical resection (NAR). In this retrospective study, we investigated the outcomes of surgical resection for small hepatocellular carcinoma and the clinical results depending on the type of hepatectomy. METHODS: We performed an analysis of the clinicopathologic factors of forty eight patients who underwent hepatectomy for a small (<2 cm) hepatocellular carcinoma between 1990 and 2005. The AR was defined as the resection based on the segment or lobe, as proposed by Couinaud. NAR was defined as the resection of a lesion without regard to the segmental or lobar anatomy, as proposed by Couinaud. The patients were divided into 2 groups base on the hepatectomy procedure: AR (n=24) and NAR (n=24). RESULTS: There were no significant difference between the two groups for the general characteristics of the patients and the clinicopathologic findings, except for ICG R15. The mean ICG R15 in the AR and NAR groups was 11.8+/-6.9 and 22.4+/-15.6, respectively, The NAR group had significantly higher ICG R15 values. The cumulative 1, 3 and 5 year overall survival rates in the AR and NAR groups were 95.8%, 68.2% and 61.3%, and 76.6%, 59.0% and 52.5%, respectively. The cumulative overall survival rate and the mean 5 year disease free survival rate in the AR group (69.8%) were higher than those of the NAR group (45.8%). However, there was no statistically significant difference. CONCLUSION: Depending on the surgical results of this study, there was no statistically significant difference in the outcomes between the AR and NAR groups.