Equivalent Outcomes After Anatomical and Non-anatomical Resection of Small Hepatocellular Carcinoma in Patients with Preserved Liver Function

Tomimaru, Yoshito; Eguchi, Hidetoshi; Marubashi, Shigeru; Wada, Hiroshi; Kobayashi, Shogo; Tanemura, Masahiro; Umeshita, Koji; Doki, Yuichiro; Mori, Masaki; Nagano, Hiroaki

doi:10.1007/s10620-012-2114-7

Cited by 51 publications

(43 citation statements)

References 31 publications

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“…On the other hand, Tomimaru et al [2] reported that the significant independent predictors for PHLF development were platelet count and volume of resected liver. In a subgroup analysis, platelet count was significantly correlated with PHLF in both larger volume (≥100 g) and smaller volume resection groups (<100 g), although ICG-R15 level was associated with PHLF only in the larger volume group.…”

Section: Discussionmentioning

confidence: 99%

“…Although various treatment strategies, such as liver resection, local ablation, transcatheter arterial chemoembolization and liver transplantation are available for HCC, liver resection is widely performed as the first-line option because of its low morbidity and mortality rates [2-4]. However, the morbidity rates after hepatectomy remain high [5-7].…”

Section: Introductionmentioning

confidence: 99%

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Impaired Value of 99m Tc-GSA Scintigraphy as an Independent Risk Factor for Posthepatectomy Liver Failure in Patients with Hepatocellular Carcinoma

et al. 2018

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Background: Posthepatectomy liver failure (PHLF) was recently defined with the corresponding recommendations as follows: grade A, no change in clinical management; grade B, clinical management with noninvasive treatment; and grade C, clinical management with invasive treatment. In this study, we identified the risk factors for grade B and C PHLF in patients with hepatocellular carcinoma (HCC). Methods: Of 339 HCC patients who underwent curative hepatic resection, 218 were included for analysis. The LHL15 index (uptake ratio of the liver to that of the liver and heart at 15 min) was measured by 99m Tc-GSA (99m technetium-labelled galactosyl human serum albumin); remnant LHL15 was calculated as LHL15 × [1 − (resected liver weight − tumor volume)/whole liver volume without tumor]. Results: A total of 163 patients were classified as having no PHLF, whereas 17, 37, and 1 patient had PHLF grade A, B, and C, respectively. There were significant differences in indocyanine green R15, serum albumin, prothrombin time, Child-Pugh classification, LHL15 and remnant LHL15 between patients with grades B/C PHLF and patients with grade A or no PHLF. Only remnant LHL15 was identified as an independent risk factor for grades B/C PHLF (p = 0.023), with a cut-off value of 0.755. Conclusions: Remnant LHL15 was an independent risk factor for grades B/C PHLF. Patients with impaired remnant LHL15 value of <0.755 should be carefully monitored for PHLF.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impaired Value of 99m Tc-GSA Scintigraphy as an Independent Risk Factor for Posthepatectomy Liver Failure in Patients with Hepatocellular Carcinoma

et al. 2018

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“…Some studies (20)(21)(22) have demonstrated the superiority of anatomical resection over non-anatomical resection for treatment of HCC. Others (23)(24)(25) have questioned the validity of this suggestion, as they found no differences in HCC recurrence or overall survival rates for patients undergoing either form of resection after resection with curative intent. However, most reported studies had limited statistical power, and no case-matched or randomized clinical trials have compared the outcomes of anatomical and non-anatomical resection for treatment of HCC.…”

Section: Anatomical Vs Non-anatomical Resectionmentioning

confidence: 99%

Recent advances in surgical treatment of hepatocellular carcinoma

Song

2015

DD&T

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“…Some studies [5,[12][13][14][15] have demonstrated the superiority of AR over non-anatomic resection (NAR) for HCC. However, the optimum liver resection technique in patients with liver dysfunction remains controversial, and there is no clear evidence that AR results in better long-term survival than does NAR [16][17][18][19]. Most of these reported studies had limited statistical power, and no case-matched or randomized clinical trials have compared the outcomes of AR and NAR for treatment of HCC.…”

Section: Introductionmentioning

confidence: 99%

Comparison of anatomic and non‐anatomic hepatic resection for hepatocellular carcinoma

Kaibori

Kon

Kitawaki

et al. 2017

J Hepato Biliary Pancreat

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Background The aim of the present study was to compare the prognostic impact of anatomic resection (AR) versus non-anatomic resection (NAR) on patient survival after resection of a single hepatocellular carcinoma (HCC). Methods To control for confounding variable distributions, a 1-to-1 propensity score match was applied to compare the outcomes of AR and NAR. Among 710 patients with a primary, solitary HCC of <5.0 cm in diameter that was resectable by either AR or NAR from 2003 to 2007 in Japan and Korea, 355 patients underwent NAR and 355 underwent AR of at least one section with complete removal of the portal territory containing the tumor. Results Overall survival (OS) was better in the AR than NAR group (hazard ratio 1.67, 95% confidence interval 1.28-2.19, P < 0.001) while disease-free survival showed no significant difference. Significantly fewer patients in the AR than NAR group developed intrahepatic HCC recurrence and multiple intrahepatic recurrences. Patients with poorly differentiated HCC who underwent AR had improved disease-free survival and OS. Conclusions Anatomic resection decreases the risk of tumor recurrence and improves OS in patients with a primary, solitary HCC of <5.0 cm in diameter.

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Equivalent Outcomes After Anatomical and Non-anatomical Resection of Small Hepatocellular Carcinoma in Patients with Preserved Liver Function

Abstract: AR of a solitary small HCC did not carry postoperative outcome advantages compared with NAR in patients with preserved liver function. We recommend NAR for hepatic resection of small solitary HCC in patients with preserved liver function.

Cited by 51 publications

References 31 publications

Impaired Value of 99m Tc-GSA Scintigraphy as an Independent Risk Factor for Posthepatectomy Liver Failure in Patients with Hepatocellular Carcinoma

Impaired Value of 99m Tc-GSA Scintigraphy as an Independent Risk Factor for Posthepatectomy Liver Failure in Patients with Hepatocellular Carcinoma

Recent advances in surgical treatment of hepatocellular carcinoma

Comparison of anatomic and non‐anatomic hepatic resection for hepatocellular carcinoma

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