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

Ye, J.Z.; Miao, Z.G.; Wu, F.X.; Zhao, Y.N.; Ye, H.H.; Li, L.Q.

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자료유형: 학술저널

저자정보: Ye, J.Z. (Guangxi Tumor Institute & Affiliated Tumor Hospital of Guangxi Medical University) Miao, Z.G. (Guangxi Tumor Institute & Affiliated Tumor Hospital of Guangxi Medical University) Wu, F.X. (Guangxi Tumor Institute & Affiliated Tumor Hospital of Guangxi Medical University) Zhao, Y.N. (Department of Hepato-Billiary Surgery, Affiliated Tumor Hospital of Guangxi Medical University) Ye, H.H. (Affiliated Minzu Hospital of Guangxi Medical University) Li, L.Q. (Affiliated Tumor Hospital of Guangxi Medical University)

저널정보: 아시아태평양암예방학회 Asian Pacific journal of cancer prevention : APJCP Asian Pacific journal of cancer prevention : APJCP 제13권 제5호

발행연도: 2012.1

수록면: 1,771 - 1,777 (7page)

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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.

#Hepatocellular carcinoma #anatomic resection #non-anatomic resection #recurrence #survival #China

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