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Anterior approach to improve the long‐term outcome in patients with large‐size hepatocellular carcinoma having liver resection
Author(s) -
Hao Shenghua,
Fan Ping,
Chen Shaofei,
Tu Caixue,
Wan Chidan
Publication year - 2016
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24433
Subject(s) - medicine , hepatocellular carcinoma , hepatectomy , gastroenterology , prospective cohort study , survival rate , multivariate analysis , resection , surgery
Background and Objective A prospective study was conducted to investigate the effect of anterior approach for hepatectomy on long‐term outcome of HCC patients with different tumor size. Methods Long‐term outcomes were investigated between patients with different tumor size underwent liver resection by either anterior or conventional approach (i.e., AA or CA group). Results The recurrence rate in AA group was much lower than that in CA group (52.4% vs.73.1%, P = 0.001). The survival rate in AA group was much higher than that in CA group (60.0% vs. 38.0%, P < 0.001). Furthermore, the differences in recurrence and survival rates in patients with large‐size tumor (>5 cm) between AA and CA groups were significant (80.0% vs. 54.7%, P = 0.002; 25.0% vs. 54.2%, P = 0.001, respectively), whereas the differences in tumor recurrence and survival rates in patients with small‐size tumor between the two groups (≤5 cm) were not significant (64.6% vs. 50.0%, P = 0.141; 56.3% vs. 65.4%, P = 0.349, respectively). Multivariate analysis found that convention approach for hepatectomy was one of the independent risk factors for HCC recurrence and poor survival. Conclusions Prognosis of patients with large‐size HCC tumor with the anterior approach was superior to that with the conventional approach. Large‐size tumor (>5 cm) could be the clinical indicator for anterior approach for hepatectomy. J. Surg. Oncol. 2016;114:872–878 . © 2016 2016 Wiley Periodicals, Inc.