title: Comparison of the outcomes between an anatomical subsegmentectomy and a non-anatomical minor hepatectomy for single hepatocellular carcinomas based on a Japanese nationwide survey.
abstract: BACKGROUND
  Although a surgical resection is an important modality for the treatment of hepatocellular carcinoma (HCC), the impact of the operative method on both the patient survival and disease-free survival (DFS) still remains controversial.
  
  
  METHODS
  Using a nationwide Japanese database, 72,744 patients with HCC who underwent a curative liver resection between 1994 and 2001 were divided into two groups based on whether an anatomical subsegmentectomy (AS) or a non-anatomical minor hepatectomy (MH) was performed. A total of 5,781 patients with single HCCs were selected for the study and divided into 3 subgroups based on the size of the HCCs (less than 2 cm, 2 to 5 cm, and greater than 5 cm in diameter). An AS was performed for 2,267 patients while an MH was performed for 3,514 patients.
  
  
  RESULTS
  The overall DFS was significantly better after an AS (P = .0089). When the patients were stratified according to the size of the HCC, a better DFS was seen in the patients with HCC from 2 to 5 cm after an AS (P < .0005). Further stratification according to liver damage did not show any significant differences between an AS and an MH.
  
  
  CONCLUSIONS
  An AS is therefore recommended, especially when the size of HCC ranges from 2 to 5 cm.
authors: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. sueguchi@nagasaki-u.acjp
authors: Susumu
authors: S
authors: Eguchi
authors: Takashi
authors: T
authors: Kanematsu
authors: Shigeki
authors: S
authors: Arii
authors: Masatoshi
authors: M
authors: Okazaki
authors: Kiwamu
authors: K
authors: Okita
authors: Masao
authors: M
authors: Omata
authors: Iwao
authors: I
authors: Ikai
authors: Masatoshi
authors: M
authors: Kudo
authors: Masamichi
authors: M
authors: Kojiro
authors: Masatoshi
authors: M
authors: Makuuchi
authors: Morito
authors: M
authors: Monden
authors: Yutaka
authors: Y
authors: Matsuyama
authors: Yasuni
authors: Y
authors: Nakanuma
authors: Kenichi
authors: K
authors: Takayasu
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D019538:Health Care Surveys; D006498:Hepatectomy / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D016896:Treatment Outcome