title: Survival after anatomic resection versus nonanatomic resection for hepatocellular carcinoma: a meta-analysis.
abstract: OBJECTIVE
  To compare the effect on survival of anatomic resection (AR) versus nonanatomic resection (NAR) in patients with hepatocellular carcinoma (HCC) from all published comparative studies in the literature.
  
  
  METHODS
  Databases, including Pubmed, Embase, the Cochrane Library, Ovid, and Web of Science, were searched to identify studies comparing AR with NAR for HCC. In this meta-analysis, primary end points were the overall survival and disease-free survival; the secondary end point was local recurrence rate. The meta-analysis was performed by use of RevMan 4.2.
  
  
  RESULTS
  Nine comparative studies comprising 1,503 patients (833 AR and 670 NAR) were identified. In the combined results, disease-free survival was significantly higher in the AR group than in the NAR group (OR 1.78, 95% CI 1.22-2.59, P = 0.003; heterogeneity P = 0.08). Overall survival (OR 1.31, 95% CI 0.92-1.85, P = 0.13; heterogeneity P = 0.04) did not suggest any significant difference between AR and NAR. No statistically significant difference was found for local recurrence rate between the two resection methods (OR 0.55, 95% CI 0.25-1.23, P = 0.15; heterogeneity P = 0.010).
  
  
  CONCLUSIONS
  Anatomic resection is associated with better disease-free survival than nonanatomic resection. Because heterogeneity was detected, caution is needed in interpretation of the results. Better designed, adequately powered studies are required to address this issue.
authors.affiliation: Department of Abdominal Surgery, Fudan University Shanghai Cancer Center, 270 Dong-An Road, 200032 Shanghai, People's Republic of China.
authors.forename: Jinggui
authors.initials: J
authors.lastname: Chen
authors.forename: Kai
authors.initials: K
authors.lastname: Huang
authors.forename: Jianghong
authors.initials: J
authors.lastname: Wu
authors.forename: Huiyan
authors.initials: H
authors.lastname: Zhu
authors.forename: Yingqiang
authors.initials: Y
authors.lastname: Shi
authors.forename: Yanong
authors.initials: Y
authors.lastname: Wang
authors.forename: Guangfa
authors.initials: G
authors.lastname: Zhao
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*