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

Abstract

Background

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).

Methods

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.

Results

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.

Conclusions

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.

Keywords

Hepatic Resection Resection Group Recurrence Pattern Anatomical Resection Intrahepatic Metastasis 

Abbreviation

AFP

α-fetoprotein

AFP-L3

LCA-reactive α-fetoprotein isoform

ALT

Alanine aminotransferase

CTAP

CT during arterial portography

CTHA

CT during hepatic arteriography

DCP

Des-γ-carboxy prothrombin

HCC

Hepatocellular carcinoma

ICG15R

15-min retention rate for indocyanine green

PT

Prothrombin time

TBF

Tumor blood flow

Notes

Disclosure

None.

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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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