Abstract
Anatomic vs. non-anatomic liver resection for hepatocellular carcinoma: standard of care or unfilled promises?
Highlights
Hepatocellular carcinoma (HCC) has the 6th highest incidence in the world and is responsible for the third most common cause of cancer-related mortality[1,2]
Despite five-year survival rates following surgical resection near 60%, less than 40% of patients newly diagnosed with HCC are suitable for partial hepatectomy due to advanced tumor biology and low HCC screening rates[4-7]
One mitigating variable controlled during partial hepatectomy is obtaining tumor-free or negative resection margins but still preserving sufficient liver parenchyma to decrease rates of post-hepatectomy liver failure
Summary
Hepatocellular carcinoma (HCC) has the 6th highest incidence in the world and is responsible for the third most common cause of cancer-related mortality[1,2]. Advances in perioperative care, and post-operative care are associated with decreased 30-day morbidity and mortality following partial hepatectomy for HCC over the past three decades. As more patients are undergoing surgical resection for HCC, it is paramount to investigate surgical methods to reduce locoregional rates of recurrence that approach nearly 50% within five years following surgery. One mitigating variable controlled during partial hepatectomy is obtaining tumor-free or negative resection margins but still preserving sufficient liver parenchyma to decrease rates of post-hepatectomy liver failure. The first is anatomic resection (AR), whereby the tumor-free margin is dependent on segmental liver anatomy and not cut liver surface margin. The second is non-anatomic resection (NAR), whereby parenchymal preservation is paramount, and tumor-free margin is contingent on the cut liver surface
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