Retrospective analysis of type of hepatic resection for hepatocellular carcinoma

Takano, Seigo; Oishi, Hidekazu; Kono, Satoru; Kawakami, Shinjiro; Nakamura, Masahiko; Katayama, Nobuyuki; Iwai, Shinichi

doi:10.1046/j.1365-2168.2000.01308.x

Cited by 49 publications

(28 citation statements)

References 16 publications

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“…Of these studies, one did not provide indications for AR and NAR [7], one focused on comparative data on the different types of hepatic resection [31], one is a nationwide survey report [19]; all three studies were excluded. Studies conducted by Imamura et al [8], Hasegawa et al [13], Suh [10], Cho et al [20], Tanaka et al [14], and Arii et al [21], respectively, were published by the same team with overlapping study populations.…”

Section: Selection Of Trialsmentioning

confidence: 99%

Meta-analysis of anatomic resection versus nonanatomic resection for hepatocellular carcinoma

Zhou

et al. 2011

Langenbecks Arch Surg

105

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Section: Selection Of Trialsmentioning

confidence: 99%

Meta-analysis of anatomic resection versus nonanatomic resection for hepatocellular carcinoma

Zhou

et al. 2011

Langenbecks Arch Surg

105

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“…No significant difference between the major hepatectomy (2 segments or more) and a minor hepatectomy group (one segment or less) could be observed in patient OS and DFS. So, a major hepatectomy is therefore not recommended for patients with solitary small HCC [61,62] . However, many other reports emphasized the importance of surgical margin in the prognosis of HCC patients.…”

Section: Surgical Marginmentioning

confidence: 99%

The prognostic significance of clinical and pathological features in hepatocellular carcinoma

Qin¹,

Tang²

2002

WJG

159

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The prognosis of patients with HCC still remains dismal. The life expectancy of HCC patients is hard to predict because of the high possibility of postoperative recurrence. Many factors, s u c h a s p a t i e n t ' s g e n e r a l c o n d i t i o n s , macroscopic tumor morphology, as well as tumor hitopathology features, have been proven of prognostic significance. Female HCC patient often has a better prognosis than male patient, which might be due to the receptor of sex hormones. Younger patients often have tumors with higher invasiveness and metastatic potentials, and their survival and prognosis are w o r s e t h a n t h e o l d e r o n e s . C o -e x i s t i n g hepatitis status and hepatic functional reserve h a v e b e e n c o n f i r m e d a s r i s k f a c t o r s f o r recurrence. Serum alpha-fetoprotein (AFP) is useful not only for diagnosis, but also as a prognostic indicator for HCC patients. AFP mRNA has been proposed as a predictive marker of HCC cells disseminated into the circulation and for metastatic recurrence. Many pathologic features, such as tumor size, number, capsule state, cell differentiation, venous invasion, intrahepatic spreading, and a d v a n c e d p T N M s t a g e , a r e t h e b e s testablished risk factors for recurrence and important aspects affecting the prognosis of patients with HCC. Marked inflammatory cell infiltration in the tumor could predict a better prognosis. Clinical stage is still the most important factor influencing on the prognosis. E x t r a t u m o r s p r e a d i n g a n d l y m p h n o d a l metastasis are independent predictors for poor outcome. Some new predictive systems h a v e r e c e n t l y b e e n p r o p o s e d . D i f f e r e n t strategies of treatment might have significant different effects on the patients' prognosis. To date, surgical resection is still the only p o t e n t i a l l y c u r a t i v e t r e a t m e n t f o r H C C , including localized postoperative recurrences. Extent of resection, blood transfusion, occlusion of porta hepatis, and blood loss affect the survival and prognosis of HCC patients. Regional therapies provide alternative ways to improve the prognosis of HCC patients who have no opportunity to receive surgical treatment or postoperative recurrence. The combination of these treatment modalities is hopeful to further improve the prognosis. The efficacies of neoadjuvant (preoperative) or adjuvant (postoperative) chemotherapy or chemoembolization in preventing recurrence and on the HCC prognosis still remain great controversy, and deserves further evaluation. Biotherapy, including IFN-alpha therapy, will play more important role in preventing recurrence and metastasis of HCC after operation.Qin LX,Tang ZY.The prognostic significance of clinical and pathological features in hepatocellular carcinoma.

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“…12 studies were excluded: 11 studies didn't provide comparative data between AR and NAR; one study (Takano et al, 2009) focused on comparative data on different types of liver resection. Studies conducted by Tanaka et al (2009) and Arii et al (Shigeki et al, 2010) were published by the same research team with overlapping study populations.…”

Section: Selection Of Studiesmentioning

confidence: 99%

Recurrence after Anatomic Resection Versus Nonanatomic Resection for Hepatocellular Carcinoma: A Meta-analysis

Miao²,

Wu³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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The impact of anatomic resection (AR) as compared to non-anatomic resection (NAR) for hepatocellular carcinoma (HCC) as a factor for preventing intra-hepatic and local recurrence after the initial surgical procedure remains controversial. A systematic review and meta-analysis of nonrandomized trials comparing anatomic resection with non-anatomic resection for HCC published from 1990 to 2010 in PubMed and Medline, Cochrane Library, Embase, and Science Citation Index were therefore performed. Intra-hepatic recurrence, including early and late, and local recurrence were considered as primary outcomes. As secondary outcomes, 5 year survival and 5 year disease-free survival were considered. Pooled effects were calculated utilizing either fixed effects or random effects models. Eleven non-randomized studies including 1,576 patients were identified and analyzed, with 810 patients in the AR group and 766 in the NAR group. Patients in the AR group were characterized by lower prevalence of cirrhosis, more favorable hepatic function, and larger tumor size and higher prevalence of macrovascular invasion compared with patients in the NAR group. Anatomic resection significantly reduced the risks of local recurrence and achieved a better 5 years disease-free survival. Also, anatomic resection was marginally effective for decreasing the early intra-hepatic recurrence. However, it was not advantageous in preventing late intra-hepatic recurrence compared with non-anatomic resection. No differences were found between AR and NAR with respect to postoperative morbidity, mortality, and hospitalization. Anatomic resection can be recommended as superior to non-anatomic resection in terms of reducing the risks of local recurrence, early intra-hepatic recurrence and achieving a better 5 year disease-free survival in HCC patients.

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Retrospective analysis of type of hepatic resection for hepatocellular carcinoma

Abstract: For tumours of 2.1 cm or more in size lobectomy appears to carry the least risk of postoperative complications and death in hospital and best achieves a cancer-free surgical margin.

Cited by 49 publications

References 16 publications

Meta-analysis of anatomic resection versus nonanatomic resection for hepatocellular carcinoma

Meta-analysis of anatomic resection versus nonanatomic resection for hepatocellular carcinoma

The prognostic significance of clinical and pathological features in hepatocellular carcinoma

Recurrence after Anatomic Resection Versus Nonanatomic Resection for Hepatocellular Carcinoma: A Meta-analysis

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