Anatomic resection reduces the recurrence of solitary hepatocellular carcinoma ≤5 cm without macrovascular invasion

Abstract Background In patients with solitary hepatocellular carcinoma ≤5 cm without macrovascular invasion, it is unknown whether the initial anatomic resection improves the long-term survival. Methods Among 545 initial hepatectomies for hepatocellular carcinoma between 2000 and 2012, the 233 patie...

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Bibliographic Details
Published in:The American journal of surgery 2014-06, Vol.207 (6), p.863-869
Main Authors: Kudo, Atsushi, M.D., Ph.D, Tanaka, Shinji, M.D., Ph.D, Ban, Daisuke, M.D., Ph.D, Matsumura, Satoshi, M.D., Ph.D, Irie, Takumi, M.D., Ph.D, Nakamura, Noriaki, M.D., Ph.D, Arii, Shigeki, M.D., Ph.D
Format: Article
Language:English
Subjects:
Aged
Anatomic resection
Biomarkers, Tumor - analysis
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - prevention & control
Carcinoma, Hepatocellular - surgery
Female
Hepatectomy
Hepatitis
Humans
Liver cancer
Liver cirrhosis
Liver dysfunction
Liver Neoplasms - pathology
Liver Neoplasms - prevention & control
Liver Neoplasms - surgery
Long-term prognosis
Male
Milan criteria
Mortality
Neoplasm Recurrence, Local - prevention & control
Neoplasm Recurrence, Local - surgery
Prognosis
Risk Factors
Small hepatocellular carcinoma
Solitary hepatocellular carcinoma
Surgery
Survival Rate
Treatment Outcome
Tumor Burden
Veins & arteries
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Summary:Abstract Background In patients with solitary hepatocellular carcinoma ≤5 cm without macrovascular invasion, it is unknown whether the initial anatomic resection improves the long-term survival. Methods Among 545 initial hepatectomies for hepatocellular carcinoma between 2000 and 2012, the 233 patients with the aforementioned criteria of hepatocellular carcinoma were enrolled. Results The mean observation time was 1,125 days. Disease-free 5-year survival rates with and without anatomic resection were 46% and 23%, respectively ( P = .009). Multivariate analyses for disease-free survival rates revealed the risk factors to be α-fetoprotein (odds ratio, 1.6; P = .028) and anatomic resection (odds ratio, .7; P = .048), while increased Child-Pugh score (>5) was the only independent risk factor for overall survival (odds ratio, 1.8; P = .043). The 5-year overall survival rates with and without Child-Pugh score 5 were 74% and 40%, respectively ( P < .0001, log-rank test). Conclusions Initial anatomic resection for small solitary hepatocellular carcinoma without macrovascular invasion improved disease-free survival rates remarkably.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2013.06.009