Anatomic resection reduces the recurrence of solitary hepatocellular carcinoma 鈮? cm without macrovascular invasion

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• 作者：Atsushi Kudo ; M.D. ; Ph.D. ; ^{kudomsrg@tmd.ac.jp" class="auth_mail} ; Shinji Tanaka ; M.D. ; Ph.D. ; Daisuke Ban ; M.D. ; Ph.D. ; Satoshi Matsumura ; M.D. ; Ph.D. ; Takumi Irie ; M.D. ; Ph.D. ; Noriaki Nakamura ; M.D. ; Ph.D. ; Shigeki Arii ; M.D. ; Ph.D.
• 关键词：Liver dysfunction ; Anatomic resection ; Long-term prognosis ; Small hepatocellular carcinoma ; Solitary hepatocellular carcinoma ; Milan criteria
• 刊名：The American Journal of Surgery
• 出版年：June 2014
• 年：2014
• 卷：207
• 期：6
• 页码：863-869
• 全文大小：861 K

文摘

In patients with solitary hepatocellular carcinoma ≤5 cm without macrovascular invasion, it is unknown whether the initial anatomic resection improves the long-term survival.

Methods

Among 545 initial hepatectomies for hepatocellular carcinoma between 2000 and 2012, the 233 patients with the aforementioned criteria of hepatocellular carcinoma were enrolled.

Results

The mean observation time was 1,125 days. Disease-free 5-year survival rates with and without anatomic resection were 46% and 23%, respectively (P = .009). Multivariate analyses for disease-free survival rates revealed the risk factors to be 伪-fetoprotein (odds ratio, 1.6; P = .028) and anatomic resection (odds ratio, .7; P = .048), while increased Child-Pugh score (>5) was the only independent risk factor for overall survival (odds ratio, 1.8; P = .043). The 5-year overall survival rates with and without Child-Pugh score 5 were 74% and 40%, respectively (P < .0001, log-rank test).

Conclusions

Initial anatomic resection for small solitary hepatocellular carcinoma without macrovascular invasion improved disease-free survival rates remarkably.