title: Comparison of the outcomes between anatomical resection and limited resection for single hepatocellular carcinomas no larger than 5 cm in diameter: a single-center study.
abstract: OBJECTIVE
  Liver resection is a widely preferred treatment modality for hepatocellular carcinomas (HCCs). This study aimed to compare the survival impact of anatomical resection with that of limited resection, in patients with single HCCs no larger than 5 cm in diameter.
  
  
  METHODS
  A cohort study was carried out on 209 consecutive patients who underwent hepatic resection for a single HCC no larger than 5 cm in diameter between January 1994 and March 2007 at Osaka City General Hospital.
  
  
  RESULTS
  The cumulative 5-year overall survival and disease-free survival rates in the anatomical resection group (n = 111) were 71 and 40%, respectively, both of which were significantly better than the 48 and 25% seen in the limited resection group (n = 98) (P = 0.0043 and P = 0.0232, respectively). Better effects of the anatomical resection on both overall and disease-free survival were seen in patients having HCC larger than 2 cm in diameter and in patients with moderately or poorly differentiated HCC. But no significant difference in either overall or disease-free survival was seen between the groups in patients with a HCC 2 cm or less in diameter or in the patients with well-differentiated HCC. Using Cox's regression model, anatomical resection was confirmed to be an independent favorable factor for both overall and disease-free survival.
  
  
  CONCLUSIONS
  Anatomical resection is therefore recommended for histologically advanced single HCCs ranging from 2 to 5 cm in diameter.
authors.affiliation: Department of Surgery, Osaka City General Hospital, 2-13-22 Miyakojimahondori Miyakojima-ku, Osaka, 534-0021, Japan. o-yamazaki@byouin.city.osaka.lg.jp
authors.forename: Osamu
authors.initials: O
authors.lastname: Yamazaki
authors.forename: Mitsuharu
authors.initials: M
authors.lastname: Matsuyama
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Horii
authors.forename: Akishige
authors.initials: A
authors.lastname: Kanazawa
authors.forename: Sadatoshi
authors.initials: S
authors.lastname: Shimizu
authors.forename: Takahiro
authors.initials: T
authors.lastname: Uenishi
authors.forename: Masao
authors.initials: M
authors.lastname: Ogawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tamamori
authors.forename: Shuichi
authors.initials: S
authors.lastname: Kawai
authors.forename: Kazunori
authors.initials: K
authors.lastname: Nakazawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Otani
authors.forename: Junya
authors.initials: J
authors.lastname: Murase
authors.forename: Shinichi
authors.initials: S
authors.lastname: Mikami
authors.forename: Ikko
authors.initials: I
authors.lastname: Higaki
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Arimoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hanba
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D011379:Prognosis