Sectionectomy Is Suitable for Patients with T2 Hepatocellular Carcinoma according to the Modified International Union against Cancer TNM Classification

Abstract

Background/Aims: The effectiveness of systematized hepatectomy in the modified International Union Against Cancer (UICC) staging classification for hepatocellular carcinoma (HCC) has not been clarified in detail. Methods: We retrospectively studied 406 patients with UICC T1 HCC and 124 patients with T2 HCC who underwent initial curative hepatectomy from 1994 through 2003. Outcomes after sectionectomy or larger resection and segmentectomy or smaller resection for patients with T1 HCC and T2 HCC were examined. Results: The overall recurrence-free survival rate and survival rate of sectionectomy or larger resection at 5 years (45 and 79%, respectively) did not significantly differ from those of segmentectomy or smaller resection (38 and 81%, respectively) in patients with T1 HCC. However, in patients with T2 HCC, the 5-year recurrence-free survival rate and survival rate after sectionectomy or larger resection (37 and 71%, respectively) were significantly different from those after segmentectomy or smaller resection (6%: p < 0.0001, and 35%: p = 0.0027, respectively). Multivariate analysis showed sectionectomy or larger resection to be a significant independent prognostic factor for recurrence-free survival and survival in patients with T2 HCC. Conclusions: Sectionectomy or larger resection prevents intrahepatic recurrence of HCC and prolongs survival in patients with T2 HCC.