Background
Although a surgical resection is an important modality for the treatment of hepatocellular
carcinoma (HCC), the impact of the operative method on both the patient survival and
disease-free survival (DFS) still remains controversial.
Methods
Using a nationwide Japanese database, 72,744 patients with HCC who underwent a curative
liver resection between 1994 and 2001 were divided into two groups based on whether
an anatomical subsegmentectomy (AS) or a non-anatomical minor hepatectomy (MH) was
performed. A total of 5,781 patients with single HCCs were selected for the study
and divided into 3 subgroups based on the size of the HCCs (less than 2cm, 2 to 5
cm, and greater than 5 cm in diameter). An AS was performed for 2,267 patients while
an MH was performed for 3,514 patients.
Results
The overall DFS was significantly better after an AS (P = .0089). When the patients were stratified according to the size of the HCC, a better
DFS was seen in the patients with HCC from 2 to 5 cm after an AS (P < .0005). Further stratification according to liver damage did not show any significant
differences between an AS and an MH.
Conclusion
An AS is therefore recommended, especially when the size of HCC ranges from 2 to 5
cm.
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Article info
Publication history
Accepted:
December 20,
2007
Footnotes
This study was performed as a group project by the Liver Cancer Study Group of Japan.
Identification
Copyright
© 2008 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
