Anatomic versus non-anatomic liver resection for hepatocellular carcinoma: a systematic review.
OBJECTIVE
To evaluate the feasibility and therapeutic effects of anatomic liver resection versus non-anatomic liver resection for hepatocellular carcinoma.


METHODS
Randomized controlled trials and non-randomized trials comparing the clinical effectiveness between anatomic and non-anatomic liver resection for hepatocellular carcinoma were identified by using a predefined search strategy. A meta-analysis was performed to estimate pooled survival and recurrence rate.


RESULTS
No Randomized controlled trial was identified. Twelve non-randomized comparative trials (10 in English and 2 in Chinese) including total 1,829 cases, 1,005 cases in anatomic resection group and 824 cases in non-anatomic resection group, were included in this review. Meta-analysis showed that there was no significant difference between anatomic and non-anatomic liver resection in 1-year survival rate (p = 0.98), 3-year survival rate (p = 0.75), 5-year survival rate (p = 0.38) and recurrence rate (p = 0.44). The differences in post-operative morbidity (p = 0.32) and blood loss during operation (p = 0.11) were also not statistically significant.


CONCLUSIONS
Anatomic liver resection for HCC does not provide significant benefit in 1-year/3-year/5-year survival rate, recurrence rate, post-operative morbidity and blood loss during operation compared with non-anatomic resection.
Yun-Hao
YH
Tang
Tian-Fu
TF
Wen
Xi
X
Chen
D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016017:Odds Ratio; D018579:Patient Selection; D011183:Postoperative Complications / Q000209:etiology; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome