title: Anatomic wide hepatectomy for treatment of hepatocellular carcinoma.
abstract: OBJECTIVE
  We aimed to clarify the prognostic impact of the anatomic extent of hepatic resection (Hr) related to the tumor hepatic involvement (H) on patients' survival in the treatment of hepatocellular carcinoma (HCC).
  
  
  METHODS
  The 305 patients with HCC who had undergone hepatectomy were analyzed retrospectively. The patients were classified into the anatomic wide hepatectomy (Hr > H hepatectomy, i.e. Hr was larger than H, n = 93) group and the other hepatectomies (Hr < or = H hepatectomy, i.e. Hr was equal to or smaller than H, n = 212) group. We compared the clinico-pathologic features between the two hepatectomy groups and the prognostic factors associated with postoperative HCC recurrence by using the Cox's proportional hazard model.
  
  
  RESULTS
  After median follow-up duration of 50 months (range 1-223 months), in Hr > H and Hr < or = H hepatectomy groups, the cumulative 3, 5, 10 year disease-free survival rates were 58.1, 44.6, 27.1% and 49.2, 33.0, 14.6%, respectively (P = 0.043). The overall survival was not significantly different between the groups (P = 0.401). Multivariate analysis revealed that Hr > H hepatectomy was an independent favorable factor for disease-free survival: the relative risk was 0.64 (95% confidence interval, 0.43-0.95; P = 0.026).
  
  
  CONCLUSIONS
  Anatomic wide (Hr > H) hepatectomy is a favorable procedure of choice in HCC for possibly reducing the risk of postoperative recurrence.
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Hirokoji-Kawaramachi, Kyoto 602-8566, Japan. tochiai@koto.kpu-m.ac.jp
authors: Toshiya
authors: T
authors: Ochiai
authors: Teruhisa
authors: T
authors: Sonoyama
authors: Shojiro
authors: S
authors: Kikuchi
authors: Tokunari
authors: T
authors: Okayama
authors: Hiroo
authors: H
authors: Konishi
authors: Masahiro
authors: M
authors: Kitagawa
authors: Tomoyuki
authors: T
authors: Tagi
authors: Yuji
authors: Y
authors: Ueda
authors: Eigo
authors: E
authors: Otsuji
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome