Effects of Anatomical or Non-Anatomical Resection of Hepatocellular Carcinoma on Survival Outcome

Background: The relative benefit of anatomical resection (AR) versus non-anatomical resection (NAR) in hepatocellular carcinoma (HCC) remains controversial. This study compared the survival outcomes and recurrence rates of HCCs analysed according to tumour size and the extent of resection. Methods:...

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Main Authors: Jae Hyun Kwon, Jung-Woo Lee, Jong Woo Lee, Young Joo Lee
Format: Article
Language:English
Published: MDPI AG 2022-03-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/11/5/1369
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author Jae Hyun Kwon
Jung-Woo Lee
Jong Woo Lee
Young Joo Lee
author_facet Jae Hyun Kwon
Jung-Woo Lee
Jong Woo Lee
Young Joo Lee
author_sort Jae Hyun Kwon
collection DOAJ
description Background: The relative benefit of anatomical resection (AR) versus non-anatomical resection (NAR) in hepatocellular carcinoma (HCC) remains controversial. This study compared the survival outcomes and recurrence rates of HCCs analysed according to tumour size and the extent of resection. Methods: Consecutive patients with HCC who underwent curative resection at Asan Medical Center between January 1999 and December 2009 were included in this study. We performed propensity score matching (PSM) according to tumour size to compare the survival outcomes between AR and NAR. A total of 986 patients were analysed; 812 and 174 patients underwent AR and NAR, respectively. Results: Before PSM, regardless of tumour size, the AR group demonstrated significantly better 5-year overall survival (OS) and recurrence-free survival (RFS) than the NAR group (<i>p</i> < 0.001). After PSM, the AR group demonstrated better OS and RFS rates than the NAR group when tumour size was less than 5 cm, but there was no significant difference in the OS and RFS rates between the two groups when tumour size was equal to or greater than 5 cm. In tumours less than 5 cm in size, AR was the most significant factor associated with OS and RFS. However, this prognostic effect of AR was not demonstrated in tumours with sizes equal to or greater than 5 cm. Conclusion: In patients with HCCs smaller than 5 cm, AR reduced the risk of tumour recurrence and improved OS. In HCCs larger than 5 cm, AR and NAR showed comparable survival outcomes.
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spelling doaj.art-6e807b373a5141a3a2ff9f96ba85b8d32023-11-23T23:14:49ZengMDPI AGJournal of Clinical Medicine2077-03832022-03-01115136910.3390/jcm11051369Effects of Anatomical or Non-Anatomical Resection of Hepatocellular Carcinoma on Survival OutcomeJae Hyun Kwon0Jung-Woo Lee1Jong Woo Lee2Young Joo Lee3Department of Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang-si 14068, Gyeonggi-do, KoreaDepartment of Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang-si 14068, Gyeonggi-do, KoreaDepartment of Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang-si 14068, Gyeonggi-do, KoreaDivision of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05535, KoreaBackground: The relative benefit of anatomical resection (AR) versus non-anatomical resection (NAR) in hepatocellular carcinoma (HCC) remains controversial. This study compared the survival outcomes and recurrence rates of HCCs analysed according to tumour size and the extent of resection. Methods: Consecutive patients with HCC who underwent curative resection at Asan Medical Center between January 1999 and December 2009 were included in this study. We performed propensity score matching (PSM) according to tumour size to compare the survival outcomes between AR and NAR. A total of 986 patients were analysed; 812 and 174 patients underwent AR and NAR, respectively. Results: Before PSM, regardless of tumour size, the AR group demonstrated significantly better 5-year overall survival (OS) and recurrence-free survival (RFS) than the NAR group (<i>p</i> < 0.001). After PSM, the AR group demonstrated better OS and RFS rates than the NAR group when tumour size was less than 5 cm, but there was no significant difference in the OS and RFS rates between the two groups when tumour size was equal to or greater than 5 cm. In tumours less than 5 cm in size, AR was the most significant factor associated with OS and RFS. However, this prognostic effect of AR was not demonstrated in tumours with sizes equal to or greater than 5 cm. Conclusion: In patients with HCCs smaller than 5 cm, AR reduced the risk of tumour recurrence and improved OS. In HCCs larger than 5 cm, AR and NAR showed comparable survival outcomes.https://www.mdpi.com/2077-0383/11/5/1369carcinomahepatocellularhepatectomytreatment outcomeprognosispropensity score
spellingShingle Jae Hyun Kwon
Jung-Woo Lee
Jong Woo Lee
Young Joo Lee
Effects of Anatomical or Non-Anatomical Resection of Hepatocellular Carcinoma on Survival Outcome
Journal of Clinical Medicine
carcinoma
hepatocellular
hepatectomy
treatment outcome
prognosis
propensity score
title Effects of Anatomical or Non-Anatomical Resection of Hepatocellular Carcinoma on Survival Outcome
title_full Effects of Anatomical or Non-Anatomical Resection of Hepatocellular Carcinoma on Survival Outcome
title_fullStr Effects of Anatomical or Non-Anatomical Resection of Hepatocellular Carcinoma on Survival Outcome
title_full_unstemmed Effects of Anatomical or Non-Anatomical Resection of Hepatocellular Carcinoma on Survival Outcome
title_short Effects of Anatomical or Non-Anatomical Resection of Hepatocellular Carcinoma on Survival Outcome
title_sort effects of anatomical or non anatomical resection of hepatocellular carcinoma on survival outcome
topic carcinoma
hepatocellular
hepatectomy
treatment outcome
prognosis
propensity score
url https://www.mdpi.com/2077-0383/11/5/1369
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