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Anatomic wide hepatectomy for treatment of hepatocellular carcinoma

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Abstract

Purpose

We aimed to clarify the prognostic impact of the anatomic extent of hepatic resection (Hr) related to the tumor hepatic involvement (H) on patients’ survival in the treatment of hepatocellular carcinoma (HCC).

Method

The 305 patients with HCC who had undergone hepatectomy were analyzed retrospectively. The patients were classified into the anatomic wide hepatectomy (Hr > H hepatectomy, i.e. Hr was larger than H, n = 93) group and the other hepatectomies (Hr < or = H hepatectomy, i.e. Hr was equal to or smaller than H, n = 212) group. We compared the clinico-pathologic features between the two hepatectomy groups and the prognostic factors associated with postoperative HCC recurrence by using the Cox’s proportional hazard model.

Results

After median follow-up duration of 50 months (range 1–223 months), in Hr > H and Hr < or = H hepatectomy groups, the cumulative 3, 5, 10 year disease-free survival rates were 58.1, 44.6, 27.1% and 49.2, 33.0, 14.6%, respectively (P = 0.043). The overall survival was not significantly different between the groups (P = 0.401). Multivariate analysis revealed that Hr > H hepatectomy was an independent favorable factor for disease-free survival: the relative risk was 0.64 (95% confidence interval, 0.43–0.95; P = 0.026).

Conclusion

Anatomic wide (Hr > H) hepatectomy is a favorable procedure of choice in HCC for possibly reducing the risk of postoperative recurrence.

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Abbreviations

AFP:

Alpha-feto protein

DFS:

Disease-free survival

HCC:

Hepatocellular carcinoma

ICG-R15:

Indocyanine green 15 min retention test

MCT:

Microwave coagulation therapy

TAE:

Transcatheter arterial chemoembolization

PEIT:

Percutaneous ethanol injection therapy

RFA:

Radiofrequency ablation

S:

Survival

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Authors and Affiliations

  1. Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji-Kawaramachi, Kamigyo-ku, Kyoto, 602-8566, Japan

    Toshiya Ochiai, Teruhisa Sonoyama, Shojiro Kikuchi, Tokunari Okayama, Hiroo Konishi, Masahiro Kitagawa, Tomoyuki Tagi, Yuji Ueda & Eigo Otsuji

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  1. Toshiya Ochiai
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  2. Teruhisa Sonoyama
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  3. Shojiro Kikuchi
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  4. Tokunari Okayama
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  5. Hiroo Konishi
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  6. Masahiro Kitagawa
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  7. Tomoyuki Tagi
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  8. Yuji Ueda
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  9. Eigo Otsuji
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Correspondence to Toshiya Ochiai.

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Ochiai, T., Sonoyama, T., Kikuchi, S. et al. Anatomic wide hepatectomy for treatment of hepatocellular carcinoma. J Cancer Res Clin Oncol 133, 563–569 (2007). https://doi.org/10.1007/s00432-007-0205-1

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  • DOI: https://doi.org/10.1007/s00432-007-0205-1

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