The Prognostic Significance of Anatomical Resection for Small Hepatocellular Carcinoma

ABSTRACT

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.