Prognostic benefit of selective portal vein occlusion during hepatic resection for hepatocellular carcinoma.
BACKGROUND
The aim of this study was to clarify whether the types of portal vein (PV) occlusion during hepatectomy affect the long-term outcome in patients with hepatocellular carcinoma (HCC).


METHODS
Eighty-six patients who had undergone curative hepatic resection for HCC were divided on the basis of the type of PV occlusion into 2 groups: total PV occlusion (TPVO, n = 56) and selective PV occlusion (SPVO, n = 30) groups. The recurrence-free survival was compared between the groups, and factors affecting recurrence-free survival were examined by univariate analyses followed by multivariate analyses. Moreover, the patients with a single nodular HCC less than 5 cm in diameter were abstracted from both groups, and the recurrence-free survival rate was compared.


RESULTS
The patients and tumor-related factors were similar in the TPVO and SPVO groups. The recurrence-free survival was better in the SPVO group than in the TPVO group (median recurrence-free survival time, 1520 vs 561 days, P = .017). The type of PV occlusion was a significant factor for recurrence-free survival by univariate analysis but did not reach significance ( P = .052) by multivariate analysis. In the selected patients who had a single nodular HCC less than 5 cm in diameter, the recurrence-free survival was also significantly better in the SPVO group than in the TPVO group (median recurrence-free survival time, 2613 vs 1003 days, P = .018).


CONCLUSIONS
Hepatectomy under selective PV occlusion seems to improve the recurrence-free survival in patients with HCC.
Makino
Ichiro
I
Department of Surgery 1, Miyazaki University, School of Medicine, Miyazaki, Japan.
Chijiiwa
Kazuo
K
Kondo
Kazuhiro
K
Ohuchida
Jiro
J
Kai
Masahiro
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008026:Ligation; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D011169:Portal Vein / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis