Anatomic resection reduces the recurrence of solitary hepatocellular carcinoma %26lt;= 5 cm without macrovascular invasion

作者：Kudo Atsushi^*; Tanaka Shinji; Ban Daisuke; Matsumura Satoshi; Irie Takumi; Nakamura Noriaki; Arii Shigeki

来源：American Journal of Surgery, 2014, 207(6): 863-869.

DOI：10.1016/j.amjsurg.2013.06.009

• Liver dysfunction
• Anatomic resection
• Long-term prognosis
• Small hepatocellular carcinoma
• Solitary hepatocellular carcinoma
• Milan criteria

BACKGROUND: In patients with solitary hepatocellular carcinoma %26lt;= 5 cm without macrovascular invasion, it is unknown whether the initial anatomic resection improves the long-term survival. %26lt;br%26gt;METHODS: Among 545 initial hepatectomies for hepatocellular carcinoma between 2000 and 2012, the 233 patients with the aforementioned criteria of hepatocellular carcinoma were enrolled. %26lt;br%26gt;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 = 5.009). Multivariate analyses for disease-free survival rates revealed the risk factors to be a-fetoprotein (odds ratio, 1.6; P = 5.028) and anatomic resection (odds ratio,.7; P = 5.048), while increased Child-Pugh score (%26gt;5) was the only independent risk factor for overall survival (odds ratio, 1.8; P = 5.043). The 5-year overall survival rates with and without Child-Pugh score 5 were 74% and 40%, respectively (P %26lt; .0001, log-rank test). %26lt;br%26gt;CONCLUSIONS: Initial anatomic resection for small solitary hepatocellular carcinoma without macrovascular invasion improved disease-free survival rates remarkably.

• 出版日期2014-6