Anatomical versus non-anatomical resection for hepatocellular carcinoma

BackgroundThe optimal surgical resection method in patients with HCC to minimize the risk of local recurrence has not yet been determined. The aim of this study was to compare the prognosis following anatomical versus non-anatomical hepatic resection for hepatocellular carcinoma (HCC). MethodsConsecutive patients with HCC without macroscopic vascular invasion, treated by curative resection between 1981 and 2012 at Osaka Medical Centre, were included in this retrospective study. The outcomes of patients selected by propensity score matching were compared. ResultsSome 1102 patients were included, 577 in the anatomical and 525 in the non-anatomical resection group. By propensity score matching, 329 patients were selected into each group. Demographic, preoperative and tumour variables were similar between the propensity score-matched groups, including tumour size, tumour multiplicity, -fetoprotein level and 15-min indocyanine green retention rate at 15min. The incidence of microvascular invasion was higher in the matched anatomical resection group (P=0048). Stratified analysis of recurrence-free and overall survival rates revealed no statistically significant differences between the two propensity score-matched groups (P=0704 and P=0381 respectively). There was also no significant difference in the early recurrence rate within 2years after resection between these groups (P=0726). Subset analysis of the early recurrence-free survival rate in patients with and without microvascular invasion revealed no significant differences between the groups (P=0312 and P=0479 respectively). ConclusionThe resection method had no impact on the risk of HCC recurrence or survival. Makes no difference