Clinical factors that affect the outcomes after anatomical versus non-anatomical resection for hepatocellular carcinoma.

Abstract

For hepatocellular carcinoma (HCC), the superiority of anatomical resection (AR) over non-anatomical resection (NR) is still controversial. In this study, we assessed the potential benefits of AR for HCC. We enrolled 173 consecutive patients with HCC who underwent hepatectomy in our hospital from August 2003 to May 2013 and compared the outcomes for the AR group (n=125) with those for the NR group (n=48). The median observational period was 790days. The 1- and 2-year overall survival (OS) rates were 92.1 and 85.8%, respectively; the 1- and 2-year disease-free survival (DFS) rates were 78.2 and 63.0%, respectively. The AR and NR groups did not significantly differ in the OS or DFS. However, the 2-year DFS was significantly better for the AR group than the NR group among HCV patients (68.2 vs. 32.2%; P=0.004) and patients with alpha-fetoprotein (AFP) within the normal range (<20ng/ml; 76.7 vs. 60.9%; P=0.031), total bilirubin <0.8mg/dl (70.8 vs. 47.0%; P=0.034), and tumors 2-5cm in diameter (82.0 vs. 62.5%; P=0.025). If a patient is HCV-negative, has low AFP, low total bilirubin, or a tumor diameter of 2-5cm, AR is recommended.