title: Comparison of Survival Outcomes Between Right Posterior Sectionectomy and Right Hepatectomy for Hepatocellular Carcinoma in Cirrhotic Liver: A Single-Centre Experience.
abstract: BACKGROUND
  Right hepatectomy (RH) instead of right posterior sectionectomy (RPS) is commonly performed for hepatocellular carcinoma (HCC) in cirrhotic livers located lateral to the right hepatic vein in order to ensure adequate resection margin. This potentially increased the risk of postoperative liver failure. This study aims to compare survival outcomes and surgical morbidities between RH and RPS.
  
  
  METHODS
  All patients between 2003 and 2013 with resection for solitary HCC in cirrhotic livers at segment 6/7 were reviewed. Baseline demographics, liver function, perioperative outcomes, and overall (OS) and disease-free survival (DFS) were compared between RH and RPS.
  
  
  RESULTS
  Eighty-one patients were included in this study. Thirty-two patients had RH and forty-nine with RPS were selected as controls. Majority of the HCC patients (91.4 %) suffered from chronic hepatitis B. There was no significant difference in age, gender and Child-Pugh grade between the two groups. The median tumour size of RH group was 6 vs. 4 cm in the RPS group (p < 0.0001). Both groups had no statistical difference in resection margin and their associated morbidities. The 5-year OS for RH and RPS was 76 and 83.8 %, respectively (p = 0.766), whereas their corresponding DFS was 52.6 and 52.2 % (p = 0.859). Despite the discrepancy of tumour size among the two groups, there was no statistical difference in subgroup analysis based on their corresponding stage of disease.
  
  
  CONCLUSIONS
  RPS can achieve similar OS and DFS as RH for HCC, and should be considered as the treatment of choice in order to optimise the postoperative remnant parenchymal liver functions.
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.|Institute of Liver Studies, King's College Hospital, Denmark Hill, SE5 9RS, London.
authors.forename: Vincent S K
authors.initials: VS
authors.lastname: Yip
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.
authors.forename: Ronnie T P
authors.initials: RT
authors.lastname: Poon
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.
authors.forename: Kenneth S H
authors.initials: KS
authors.lastname: Chok
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.
authors.forename: Albert C Y
authors.initials: AC
authors.lastname: Chan
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.
authors.forename: Wing Chiu
authors.initials: WC
authors.lastname: Dai
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.
authors.forename: Simon H Y
authors.initials: SH
authors.lastname: Tsang
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.
authors.forename: See Ching
authors.initials: SC
authors.lastname: Chan
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.
authors.forename: Chung Mau
authors.initials: CM
authors.lastname: Lo
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China. tantocheung@hotmail.com.
authors.forename: Tan To
authors.initials: TT
authors.lastname: Cheung
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000379:methods* / Q000401:mortality; D006503:Hepatic Veins / Q000601:surgery; D019694:Hepatitis B, Chronic / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D017093:Liver Failure; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D015996:Survival Rate; D047368:Tumor Burden