Anatomic resection reduces the recurrence of solitary hepatocellular carcinoma ≤ 5 cm without macrovascular invasion

BACKGROUND: 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 = 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 (>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 < .0001, log-rank test). CONCLUSIONS: Initial anatomic resection for small solitary hepatocellular carcinoma without macrovascular invasion improved disease-free survival rates remarkably. (C) 2014 Elsevier Inc. All rights reserved.