title: Anatomical versus non-anatomical resection for hepatocellular carcinoma.
abstract: BACKGROUND
  The optimal surgical resection method in patients with HCC to minimize the risk of local recurrence has not yet been determined. The aim of this study was to compare the prognosis following anatomical versus non-anatomical hepatic resection for hepatocellular carcinoma (HCC).
  
  
  METHODS
  Consecutive patients with HCC without macroscopic vascular invasion, treated by curative resection between 1981 and 2012 at Osaka Medical Centre, were included in this retrospective study. The outcomes of patients selected by propensity score matching were compared.
  
  
  RESULTS
  Some 1102 patients were included, 577 in the anatomical and 525 in the non-anatomical resection group. By propensity score matching, 329 patients were selected into each group. Demographic, preoperative and tumour variables were similar between the propensity score-matched groups, including tumour size, tumour multiplicity, α-fetoprotein level and 15-min indocyanine green retention rate at 15 min. The incidence of microvascular invasion was higher in the matched anatomical resection group (P = 0·048). Stratified analysis of recurrence-free and overall survival rates revealed no statistically significant differences between the two propensity score-matched groups (P = 0·704 and P = 0·381 respectively). There was also no significant difference in the early recurrence rate within 2 years after resection between these groups (P = 0·726). Subset analysis of the early recurrence-free survival rate in patients with and without microvascular invasion revealed no significant differences between the groups (P = 0·312 and P = 0·479 respectively).
  
  
  CONCLUSIONS
  The resection method had no impact on the risk of HCC recurrence or survival.
authors.affiliation: Department of Surgery, Osaka Medical Centre for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Marubashi
authors.forename: K
authors.initials: K
authors.lastname: Gotoh
authors.forename: H
authors.initials: H
authors.lastname: Akita
authors.forename: H
authors.initials: H
authors.lastname: Takahashi
authors.forename: Y
authors.initials: Y
authors.lastname: Ito
authors.forename: M
authors.initials: M
authors.lastname: Yano
authors.forename: O
authors.initials: O
authors.lastname: Ishikawa
authors.forename: M
authors.initials: M
authors.lastname: Sakon
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008099:Liver / Q000033:anatomy & histology*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D057216:Propensity Score; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome