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Clinical factors that affect the outcomes after anatomical versus non-anatomical resection for hepatocellular carcinoma

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Abstract

Purpose

For hepatocellular carcinoma (HCC), the superiority of anatomical resection (AR) over non-anatomical resection (NR) is still controversial. In this study, we assessed the potential benefits of AR for HCC.

Methods

We enrolled 173 consecutive patients with HCC who underwent hepatectomy in our hospital from August 2003 to May 2013 and compared the outcomes for the AR group (n = 125) with those for the NR group (n = 48).

Results

The median observational period was 790 days. The 1- and 2-year overall survival (OS) rates were 92.1 and 85.8 %, respectively; the 1- and 2-year disease-free survival (DFS) rates were 78.2 and 63.0 %, respectively. The AR and NR groups did not significantly differ in the OS or DFS. However, the 2-year DFS was significantly better for the AR group than the NR group among HCV patients (68.2 vs. 32.2 %; P = 0.004) and patients with alpha-fetoprotein (AFP) within the normal range (<20 ng/ml; 76.7 vs. 60.9 %; P = 0.031), total bilirubin <0.8 mg/dl (70.8 vs. 47.0 %; P = 0.034), and tumors 2–5 cm in diameter (82.0 vs. 62.5 %; P = 0.025).

Conclusions

If a patient is HCV-negative, has low AFP, low total bilirubin, or a tumor diameter of 2–5 cm, AR is recommended.

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Authors and Affiliations

  1. Department of Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, Japan

    Takehito Yamamoto, Shintaro Yagi, Kenji Uryuhara, Satoshi Kaihara & Ryo Hosotani

  2. Department of Gastroenterological Surgery and Oncology, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 2-4-20 Ogimachi, Kita-ku, Osaka, Japan

    Takehito Yamamoto

  3. Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University Graduate School of Medicine, 54 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, Kyoto, Japan

    Shintaro Yagi

Authors
  1. Takehito Yamamoto
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  2. Shintaro Yagi
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Correspondence to Shintaro Yagi.

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The authors declare no conflicts of interest, including supporting grants and presentations.

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Yamamoto, T., Yagi, S., Uryuhara, K. et al. Clinical factors that affect the outcomes after anatomical versus non-anatomical resection for hepatocellular carcinoma. Surg Today 47, 193–201 (2017). https://doi.org/10.1007/s00595-016-1397-2

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  • DOI: https://doi.org/10.1007/s00595-016-1397-2

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