Department of Surgery, Nara Medical University, Japan.
Department of Surgery, Nara Medical University, Japan.
Surgery. 2018 Feb;163(2):285-290. doi: 10.1016/j.surg.2017.08.024. Epub 2017 Nov 28.
It is unclear whether anatomic resection achieves better outcomes than nonanatomic resection in patients with hepatocellular carcinoma. This study aimed to compare the outcomes of anatomic resection and nonanatomic resection for hepatocellular carcinoma located on the liver surface via one-to-one propensity score-matching analysis.
Data from all consecutive patients who underwent liver resection for primary solitary hepatocellular carcinoma at Nara Medical University Hospital, Japan, January 2007- December 2015 were retrieved. Superficial hepatocellular carcinomas were defined as hepatocellular carcinoma that extended to a depth of < 3 cm from the liver surface and measured < 5 cm in diameter. The prognoses of the patients with superficial hepatocellular carcinoma who underwent anatomic resection and nonanatomic resection were compared.
In this study 23 patients with superficial hepatocellular carcinoma underwent anatomic resection and 70 patients who underwent nonanatomic resection. The recurrence-free survival rate of the patients who underwent anatomic resection was better than that of the patients who underwent nonanatomic resection (P = .006), while no such difference was observed for nonsuperficial hepatocellular carcinoma. After the propensity score-matching procedure, the resected liver volume and operation time were the only background or clinical characteristics to exhibit significant differences between the anatomic resection (n = 20) and nonanatomic resection groups (n = 20). The recurrence-free survivial rate of the patients who underwent anatomic resection was significantly than that of the patients that underwent nonanatomic resections (P = .030), but overall survival did not differ significantly between the groups (P = .182).
Anatomic resection decreases the risk of tumor recurrence and improves recurrence-free survival compared with nonanatomic resection in patients with superficial hepatocellular carcinoma.
目前尚不清楚解剖性肝切除术与非解剖性肝切除术治疗肝癌患者的疗效孰优孰劣。本研究旨在通过一对一倾向评分匹配分析，比较肝表面肝癌行解剖性肝切除和非解剖性肝切除的疗效。
本研究回顾性分析了日本奈良医科大学医院 2007 年 1 月至 2015 年 12 月期间所有因原发性单发肝癌接受肝切除术患者的临床资料。浅表性肝癌是指距离肝表面深度<3cm，直径<5cm 的肝癌。比较了浅表性肝癌患者行解剖性肝切除和非解剖性肝切除的预后。
本研究中 23 例浅表性肝癌患者行解剖性肝切除，70 例患者行非解剖性肝切除。解剖性肝切除患者的无复发生存率优于非解剖性肝切除患者（P=0.006），而在非浅表性肝癌患者中则无差异。在倾向评分匹配后，解剖性肝切除组（n=20）和非解剖性肝切除组（n=20）的唯一背景或临床特征是切除的肝体积和手术时间存在显著差异。解剖性肝切除患者的无复发生存率显著高于非解剖性肝切除患者（P=0.030），但两组的总体生存率无显著差异（P=0.182）。
与非解剖性肝切除术相比，解剖性肝切除术可降低浅表性肝癌患者肿瘤复发风险，提高无复发生存率。
