This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wakai, T. Articles by Hatakeyama, K. Search for Related Content PubMed PubMed Citation Articles by Wakai, T. Articles by Hatakeyama, K.

Anatomic Resection Independently Improves Long-Term Survival in Patients with T1–T2 Hepatocellular Carcinoma

¹ Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata City, 951-8510, Japan
² Department of Medical Informatics, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Niigata City, 951-8520, Japan

Correspondence: Address correspondence and reprint requests to: Yoshio Shirai, MD, PhD; E-mail: shiray{at}med.niigata-u.ac.jp

Background: This study aimed to evaluate the effect of anatomic resection on long-term outcomes in patients with pathologic T1–T2 (pT1–T2) hepatocellular carcinoma.

Methods: A retrospective analysis of 158 consecutive patients who underwent either anatomic (n = 95) or nonanatomic (n = 63) resection for pT1–T2 hepatocellular carcinoma was conducted. Anatomic resection was defined as the complete removal of at least one Couinaud segment containing the tumor; nonanatomic resection was defined as removal of the tumor plus a rim of nonneoplastic liver parenchyma. The median follow-up time was 83 months.

Results: Patients who underwent anatomic resection were characterized by lower prevalence of cirrhosis (P = .015), more favorable hepatic function (P = .001), larger tumor size (P = .029), and higher prevalence of vascular invasion (P = .008) compared with patients who underwent nonanatomic resection. Anatomic resection provided better survival (median survival time, 122 months) than nonanatomic resection (median survival time, 76 months; P = .0358). Patients who underwent anatomic resection had better disease-free survival (P = .0121). Anatomic resection independently improved both survival (hazard ratio, .46; P = .003) and disease-free survival (hazard ratio, .55; P = .008). When stratified for pT classification, the effectiveness of anatomic resection remained only in patients with pT2 tumors in terms of survival (P = .0012) and disease-free survival (P = .0004).

Conclusions: Anatomic resection independently improves long-term survival in patients with T1–T2 hepatocellular carcinoma, probably because of the clearance of venous tumor thrombi within the resected domain.

Key Words: Liver neoplasms • Hepatocellular carcinoma • Anatomic resection • Nonanatomic resection • Multivariate analysis • Prognosis

This article has been cited by other articles:

				K. S. Lehmann, J.-P. Ritz, S. Valdeig, A. Schenk, C. Holmer, H.-O. Peitgen, H.-J. Buhr, and B. B. Frericks Portal Vein Segmentation of a 3D-Planning System for Liver Surgery--In vivo Evaluation in a Porcine Model Ann. Surg. Oncol., July 1, 2008; 15(7): 1899 - 1907. [Abstract] [Full Text] [PDF]