Long-Term Outcomes of Anatomic Versus Nonanatomic Resection in Hepatocellular Carcinoma Patients with Bile Duct Tumor Thrombus: A Propensity Score Matching Analysis

Background Anatomic resection (AR) of the liver is generally recommended in hepatocellular carcinoma (HCC) patients. However, the benefits of AR and nonanatomic resection (NAR) in HCC patients with bile duct tumor thrombus (BDTT) are unknown. This study aimed to compare long-term outcomes of AR and...

Full description

Saved in:
Bibliographic Details
Published in:Annals of surgical oncology 2021-11, Vol.28 (12), p.7686-7695
Main Authors: Wu, Jia-Yi, Sun, Ju-Xian, Bai, Yan-Nan, Huang, Xiao-Xiao, Wu, Jun-Yi, Wei, Yong-Gang, Zhang, Zhi-Bo, Zhou, Jian-Yin, Wang, Yao-Dong, Cheng, Shu-Qun, Yan, Mao-Lin
Format: Article
Language:English
Subjects:
Bile ducts
Blood clots
Hepatobiliary Tumors
Hepatocellular carcinoma
Liver cancer
Medicine
Medicine & Public Health
Multivariate analysis
Oncology
Statistical analysis
Surgery
Surgical Oncology
Survival
Thrombosis
Tumors
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Anatomic resection (AR) of the liver is generally recommended in hepatocellular carcinoma (HCC) patients. However, the benefits of AR and nonanatomic resection (NAR) in HCC patients with bile duct tumor thrombus (BDTT) are unknown. This study aimed to compare long-term outcomes of AR and NAR in HCC patients with BDTT after curative resection. Patients and Methods A total of 175 consecutive HCC patients with BDTT after curative resection between April 2009 and December 2017 were included. One-to-one propensity score matching (PSM) was performed to minimize the influence of potential confounders. Recurrence-free survival (RFS) and overall survival (OS) were compared between the cohorts. Results After PSM, 120 patients were analyzed. The AR group had better RFS than the NAR group ( P = 0.010). Even though there was no statistically significant difference in OS ( P = 0.140, power = 0.33), the 3- and 5-year OS rates in the AR group (52.4% and 44.2%, respectively) were obviously higher than those in the NAR group (35.4% and 30.4%, respectively). When patients were further stratified according to tumor size, better RFS and OS were observed in patients with small (≤ 5 cm) tumors after AR ( P < 0.001 and P = 0.004, respectively). Multivariate analysis identified AR ( P = 0.024) as an independent favorable prognostic factor for RFS in HCC patients with BDTT. Conclusions AR is recommended for HCC patients with BDTT, especially in patients with small (≤ 5 cm) tumors.
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-021-09874-3