Anatomic wide hepatectomy for treatment of hepatocellular carcinoma.
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.
Ochiai
Toshiya
T
Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Hirokoji-Kawaramachi, Kyoto 602-8566, Japan. tochiai@koto.kpu-m.ac.jp
Sonoyama
Teruhisa
T
Kikuchi
Shojiro
S
Okayama
Tokunari
T
Konishi
Hiroo
H
Kitagawa
Masahiro
M
Tagi
Tomoyuki
T
Ueda
Yuji
Y
Otsuji
Eigo
E
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