Anatomic wide hepatectomy for treatment of hepatocellular carcinoma.

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.