Annals of Surgical Oncology

, Volume 22, Issue 7, pp 2243–2252 | Cite as

Analysis of Recurrence Patterns After Anatomical or Non-anatomical Resection for Hepatocellular Carcinoma

  • Shigeru Marubashi
  • Kunihito Gotoh
  • Hirofumi Akita
  • Hidenori Takahashi
  • Keijiro Sugimura
  • Norikatsu Miyoshi
  • Masaaki Motoori
  • Kentaro Kishi
  • Shingo Noura
  • Yoshiyuki Fujiwara
  • Masayuki Ohue
  • Tetsuro Nakazawa
  • Katsuyuki Nakanishi
  • Yuri Ito
  • Masahiko Yano
  • Osamu Ishikawa
  • Masato Sakon
Hepatobiliary Tumors



Recurrence patterns after hepatic resection has been poorly understood in view of tumor blood flow drainage (TBFD) area. Our goal was to clarify the recurrence patterns after anatomical versus nonanatomical hepatic resection for hepatocellular carcinoma (HCC).


A total of 424 consecutive patients with HCC, who were treated by curative resection (R0) at our hospital from 2001 to 2012, were evaluated. Among these, we compared the outcomes of the anatomical resection group (AR group, n = 243) and the nonanatomical resection group (NR group, n = 181). We performed an analysis of the recurrence patterns of HCC based on the preoperative CT during hepatic arteriography in these 424 patients.


Preoperative liver function was better in the AR group than the NR group (P < 0.001), and tumor size was larger in the AR group than the NR group (P < 0.001). HCC recurrence was recorded in 145 patients (59.7 %) of the AR group and 102 patients (56.4 %) of the NR group with no significant differences between the two groups (P = 0.590). The incidences of extrahepatic and intrahepatic recurrence (solitary/multiple) were similar between the two groups. In addition, the rate of recurrences by local dissemination, either recurrences in the same subsegment in the NR group or recurrences in the TBFD area in the AR group, was sufficiently low (1.4 %) as to be considered negligible.


The incidence and patterns of HCC recurrence were similar between the anatomical and nonanatomical resection. Recurrence by local dissemination may be considered to be negligible in both surgical methods.


Hepatic Resection Resection Group Recurrence Pattern Anatomical Resection Intrahepatic Metastasis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.





LCA-reactive α-fetoprotein isoform


Alanine aminotransferase


CT during arterial portography


CT during hepatic arteriography


Des-γ-carboxy prothrombin


Hepatocellular carcinoma


15-min retention rate for indocyanine green


Prothrombin time


Tumor blood flow





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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Shigeru Marubashi
    • 1
  • Kunihito Gotoh
    • 1
  • Hirofumi Akita
    • 1
  • Hidenori Takahashi
    • 1
  • Keijiro Sugimura
    • 1
  • Norikatsu Miyoshi
    • 1
  • Masaaki Motoori
    • 1
  • Kentaro Kishi
    • 1
  • Shingo Noura
    • 1
  • Yoshiyuki Fujiwara
    • 1
  • Masayuki Ohue
    • 1
  • Tetsuro Nakazawa
    • 2
  • Katsuyuki Nakanishi
    • 2
  • Yuri Ito
    • 3
  • Masahiko Yano
    • 1
  • Osamu Ishikawa
    • 1
  • Masato Sakon
    • 1
  1. 1.Department of SurgeryOsaka Medical Center for Cancer and Cardiovascular DiseasesOsakaJapan
  2. 2.Department of RadiologyOsaka Medical Center for Cancer and Cardiovascular DiseasesOsakaJapan
  3. 3.Center for Cancer Control and StatisticsOsaka Medical Center for Cancer and Cardiovascular DiseasesOsakaJapan

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