title: Prognostic benefit of selective portal vein occlusion during hepatic resection for hepatocellular carcinoma.
abstract: 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.
authors.affiliation: Department of Surgery 1, Miyazaki University, School of Medicine, Miyazaki, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Makino
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chijiiwa
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kondo
authors.forename: Jiro
authors.initials: J
authors.lastname: Ohuchida
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kai
mesh_terms: 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