Surgical intervention of hepatocellular carcinoma with wedge versus segmental resection: A SEER database analysis.

Abstract

e16136 Background: Hepatocellular carcinoma (HCC) is the most common primary liver malignancy, constituting 75-85% of liver cancer cases globally. In recent years there have been developments in both the clinical treatment methods and surgical approaches to HCC treatment, however, the prognosis for patients with HCC remains dismal. Two of the major surgical treatment options for HCC are wedge resections and segmental resection with the latter having up to three segments of the liver being removed. This study assessed the prognostic impact between these two surgical treatment options in the management of HCC liver cancer. Methods: We searched the SEER-18 database for HCC cases (histology codes 8170-8175) diagnosed between 2000-2018. Patients were excluded if their cause of death was not associated with their HCC diagnosis according to SEER’s cancer-specific death categorization. The SEER database tracks survival up to 60 months. Using SPSS, we performed analyses on the association between surgical subtype and survival, which is tracked up to 60 months in the SEER database. Results: A total of 3919 patients were collected from this search. Of that patient collection, 643 patients received a wedge resection and a total of 2609 patients received a segmental resection. There were 366 patients that received a segmental resection with local tumor destruction. 667 patient resections were not differentiated between segmental or wedge resections. The segmental resection of an unspecified number, the one segment resection, and the two segments resection groups all had better mean survival compared to the wedge resection group and segmental resection with local tumor destruction group (all p < 0.05). The three segments resection compared to wedge resection had no difference in survivability (p > 0.05). The three-segment resection had worse survivability when compared to both one and two-segment resections (p < 0.01). The one-segment resection had no difference in survivability when compared to the two-segment resection procedure (p > 0.05). Conclusions: Though limitations of small sample size and univariate statistical analyses were present in this study, one or two segment resection is associated with improved survival compared to wedge resection, the three segment resection and the segmental with local tumor destruction approach used in the treatment of HCC.[Table: see text]