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01-04-2007 | Hepatic and Pancreatic Tumors

Anatomic Resection Independently Improves Long-Term Survival in Patients with T1–T2 Hepatocellular Carcinoma

Authors: Toshifumi Wakai, MD, PhD, Yoshio Shirai, MD, PhD, Jun Sakata, MD, PhD, Kazuhiro Kaneko, MD, Pauldion V. Cruz, MD, PhD, Kouhei Akazawa, MD, PhD, Katsuyoshi Hatakeyama, MD, PhD, FACS

Published in: Annals of Surgical Oncology | Issue 4/2007

Abstract

Background

This study aimed to evaluate the effect of anatomic resection on long-term outcomes in patients with pathologic T1–T2 (pT1–T2) hepatocellular carcinoma.

Methods

A retrospective analysis of 158 consecutive patients who underwent either anatomic (n = 95) or nonanatomic (n = 63) resection for pT1–T2 hepatocellular carcinoma was conducted. Anatomic resection was defined as the complete removal of at least one Couinaud segment containing the tumor; nonanatomic resection was defined as removal of the tumor plus a rim of nonneoplastic liver parenchyma. The median follow-up time was 83 months.

Results

Patients who underwent anatomic resection were characterized by lower prevalence of cirrhosis (P = .015), more favorable hepatic function (P = .001), larger tumor size (P = .029), and higher prevalence of vascular invasion (P = .008) compared with patients who underwent nonanatomic resection. Anatomic resection provided better survival (median survival time, 122 months) than nonanatomic resection (median survival time, 76 months; P = .0358). Patients who underwent anatomic resection had better disease-free survival (P = .0121). Anatomic resection independently improved both survival (hazard ratio, .46; P = .003) and disease-free survival (hazard ratio, .55; P = .008). When stratified for pT classification, the effectiveness of anatomic resection remained only in patients with pT2 tumors in terms of survival (P = .0012) and disease-free survival (P = .0004).

Conclusions

Anatomic resection independently improves long-term survival in patients with T1–T2 hepatocellular carcinoma, probably because of the clearance of venous tumor thrombi within the resected domain.

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Title: Anatomic Resection Independently Improves Long-Term Survival in Patients with T1–T2 Hepatocellular Carcinoma
Authors: Toshifumi Wakai, MD, PhD
Yoshio Shirai, MD, PhD
Jun Sakata, MD, PhD
Kazuhiro Kaneko, MD
Pauldion V. Cruz, MD, PhD
Kouhei Akazawa, MD, PhD
Katsuyoshi Hatakeyama, MD, PhD, FACS
Publication date: 01-04-2007
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 4/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-006-9318-z

At a glance: The STEP trials

Springer Medicine

Anatomic Resection Independently Improves Long-Term Survival in Patients with T1–T2 Hepatocellular Carcinoma

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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