Anterior approach to improve the long-term outcome in patients with large-size hepatocellular carcinoma having liver resection

作者：Hao, Shenghua^*; Fan, Ping; Chen, Shaofei; Tu, Caixue; Wan, Chidan

来源：Journal of Surgical Oncology, 2016, 114(7): 872-878.

DOI：10.1002/jso.24433

• hepatocellular carcinoma
• hepatectomy
• recurrence
• survival
• anterior approach
• conventional approach

Background and ObjectiveA prospective study was conducted to investigate the effect of anterior approach for hepatectomy on long-term outcome of HCC patients with different tumor size.
MethodsLong-term outcomes were investigated between patients with different tumor size underwent liver resection by either anterior or conventional approach (i.e., AA or CA group).
ResultsThe recurrence rate in AA group was much lower than that in CA group (52.4% vs.73.1%, P=0.001). The survival rate in AA group was much higher than that in CA group (60.0% vs. 38.0%, P<0.001). Furthermore, the differences in recurrence and survival rates in patients with large-size tumor (>5cm) between AA and CA groups were significant (80.0% vs. 54.7%, P=0.002; 25.0% vs. 54.2%, P=0.001, respectively), whereas the differences in tumor recurrence and survival rates in patients with small-size tumor between the two groups (5cm) were not significant (64.6% vs. 50.0%, P=0.141; 56.3% vs. 65.4%, P=0.349, respectively). Multivariate analysis found that convention approach for hepatectomy was one of the independent risk factors for HCC recurrence and poor survival.
ConclusionsPrognosis of patients with large-size HCC tumor with the anterior approach was superior to that with the conventional approach. Large-size tumor (>5cm) could be the clinical indicator for anterior approach for hepatectomy. J. Surg. Oncol. 2016;114:872-878.

• 出版日期2016-12-1
• 单位华中科技大学