The Long-term Outcomes of Hepatic Resection Between Single Tumor and Multiple Tumors of HCC Meeting UCSF Criteria

Abstract

Object: Searching the hepatectomy of hepatocellular carcinoma (HCC) within UCSF is limited. The study aims to compare the long-term surgical outcomes between single and multiple tumors to find an effective and safe treatment for the patients within UCSF criteria.Methods: We have enrolled 1006 patients meeting UCSF criteria, including 744 patients with single tumor and 262 patients with multiple tumors undergoing hepatic resection (HR). We divided the patients into two groups: single tumor group and multiple tumor group. By comparing the long-term outcomes between these two groups and analyzing the risk factors by the log-rank test and cox proportional hazards model in two groups.Results: The 1-, 3-, and 5-year OS rates in the single tumor group were significantly higher than the multiple tumors group (96.2%, 65.3% and 40.1% versus 93.1%, 47.6% and 22.5%, respectively, p<0.001). The 1-, 3- and 5-year RFS rates were 91.4%, 46.2%, and 24.6% in the single group and 90.8%, 31.1% and 13.0%, respectively (p<0.001). And the anatomic resection and MVI were the independent risk factors for single tumor, but it didn’t work for multiple tumors. The independent risk factors of multiple tumors are the diameter more than 2cm of the maximum tumor and the tumors located in different segments.Conclusion: The surgical resection will obtain a better outcomes for the HCC with single tumor meeting UCSF criteria than the multiple tumors. And the anatomic resection should be applied for the patients with single tumor, if possible.