Anatomic Versus Non-Anatomic Resection For Small Single Hepatocellular Carcinomas And Analysis Of Prognostic Factors

Objective:To compare the efficacy of anatomic resection (AR) and non-anatomic resection (NAR) for single small hepatocellular carcinoma (HCC).Methods:Between June 1,2006 and December 31,2011, one hundred and forty patients underwent curative hepatectomy for a single HCC<5cm at Guangxi Tumor Hospital. Of these patients, forty-four underwent anatomic resection (AR group) and 96 patients underwent non-anatomic resection (NAR group). The 1-,3- and 5-year recurrence-free survival (RFS) and overall survival rates (OS) of the two groups were compared.Result:The 1-,3- and 5-year RFS were 67.5%,44.1% and 39.2% in the AR group and 77.2%,52.6% and 28.0% in the NAR group, respectively (x2= 0.271, P= 0.602). The corresponding 1,-3-and 5-year OS were 93.2%,88.0% and 72.2% in the AR group and 99.0%,91.4% and 80.2% in the NAR group (x2=0.645, P= 0.422). In multivariate analysis, serum albumin level, tumor size and presence of cirrhosis were independent prognostic factors for OS, while absence of tumor capsule and tumor size more than 3cm were independent risk factors for RFS.Conclusion:No significant difference was observed in terms of survival in anatomic resection and non-anatomic resection. Non-anatomic resection was not a prognostic factor for OS. However, liver function reserve was more significant. It should be advised to select an optimal operative procedure according to the liver function and location of the tumor for the surgical treatment of small hepatocellular carcinomas preoperatively.