The Incidence of Early Recurrence After Anatomical Versus Non-Anatomical Liver Resection in Patients with Hepatocellular Carcinoma

Abstract

<i>Aim:</i> This retrospective study compares the incidence of early recurrence after anatomical versus non-anatomical resection in patients with hepatocellular carcinoma (HCC). <i>Patients and Methods:</i> This retrospective study included 26 patients who had a preoperative diagnosis of a single hepatocellular carcinoma (HCC) and who underwent anatomical and non-anatomical liver resection. The patients were divided into two groups. AR Group; anatomical resection group (n= 12) and NAR Group; Non-anatomical resection group (n = 14). The effect of the type of resection (anatomic vs non-anatomic) on early HCC recurrence was studied in both groups. Other risk factors that might play a role in early tumor recurrence such as the TNM staging, tumor size, vascular invasion, pathologic grading and high AFP values were also evaluated. <i>Results:</i> During the follow up period, 5 patients (41.7 %) from AR Group and 6 patients (42.9 %) from NAR Group developed recurrence. Mean time of recurrence was 13.05 ± 4.63 versus 12.53 ± 4.12 months (p 0.764). The univariate analysis method was used to analyze different epidemiological, clinical and pathological variables and there was no statistically significant risk factor in both groups in terms of recurrence. The mean disease-free survival was calculated for both groups using Kaplan–Meier curve and it was 16.013±2.324 for AR group versus 15.657±2.765 months for NAR group (p: 0.98). The cumulative overall survival proportion at end of research was 59.6% for AR group versus 69.87% for NAR group. The mean overall survival was 17.956±2.254 months for AR group versus 20.876±1.263 for NAR group (p: 0.21). The recurrence rate was 41.7%% in AR group and 42.9% in NAR group (p = 0.951). This suggests that the type of resection did not have an impact on early recurrence in HCC patients undergoing liver resection. <i>Conclusion:</i> This study concluded that recurrence-free and overall survivals after both anatomical and non-anatomical resection were not significantly different from the statistical point of view. Liver resection in cirrhotic patients should be performed with good expertise and should pursue strict selection criteria. Non-Anatomical resection may be more appropriate in cirrhotic patients with small HCC to preserve adequate functioning hepatic parenchyma and to avoid increased postoperative morbidity and mortality.