title: Surgical outcomes of anatomical resection for solitary recurrent hepatocellular carcinoma.
abstract: BACKGROUND
  For eradicating portal venous tumor extension and intrahepatic metastasis in hepatocellular carcinoma (HCC), anatomical resection is, in theory, preferable.
  
  
  METHODS
  We carried-out a retrospective cohort study in 110 patients who underwent curative hepatic resection (anatomical resection; n=20, and limited resection; n=90) for solitary recurrent HCC from 1990-2010.
  
  
  RESULTS
  No significant difference was found in short-term surgical results such as mortality, morbidity, and duration of hospital stay between the two groups. Anatomical resection did not influence overall and disease-free survival for all patients with a solitary recurrent HCC. In patients with cancer spread, such as pathological vascular invasion and intrahepatic metastasis (n=61), or with des-γ-carboxy prothrombin (DCP) ≥ 100 mAU/ml (n=73), the disease-free survival rate in the anatomical-resection group was significantly better than that in the limited-resection group (p=0.0452 and p=0.0345, respectively).
  
  
  CONCLUSIONS
  Anatomical resection should be recommended only for HCC suspected of exhibiting cancer spread as reflected by DCP ≥ 100 mAU/ml in patients with solitary recurrent HCC.
authors: Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Naka-ku, Hiroshima, Japan Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan yamashi@surg2.med.kyushu-u.ac.jp.
authors: Yo-Ichi
authors: Y
authors: Yamashita
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
authors: Daisuke
authors: D
authors: Imai
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
authors: Yuki
authors: Y
authors: Bekki
authors: Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Naka-ku, Hiroshima, Japan.
authors: Kazuki
authors: K
authors: Takeishi
authors: Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Naka-ku, Hiroshima, Japan.
authors: Eiji
authors: E
authors: Tsujita
authors: Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Naka-ku, Hiroshima, Japan Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
authors: Toru
authors: T
authors: Ikegami
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
authors: Tomoharu
authors: T
authors: Yoshizumi
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
authors: Tetsuo
authors: T
authors: Ikeda
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
authors: Ken
authors: K
authors: Shirabe
authors: Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Naka-ku, Hiroshima, Japan.
authors: Teruyoshi
authors: T
authors: Ishida
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
authors: Yoshihiko
authors: Y
authors: Maehara
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011498:Protein Precursors / Q000097:blood; D011516:Prothrombin; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D011498:Protein Precursors; C008208:acarboxyprothrombin; D011516:Prothrombin
keywords: Recurrent hepatocellular carcinoma; anatomical resection; cancer spread; disease-free survival; overall survival; prognostic factors