Efficacy Of Anatomic Hepatectomy In Treatment Of Primary Small Hepatocellular Carcinoma:A Meta-analysis

Objective : the most effective treatment for hepatocellular carcinoma(hepatocellular carcinoma,HCC)is surgical resection currently.But the short-term and long-term efficacy of anatomic resection(AR)and non-anatomic resection(NAR)for hepatocellular carcinoma remains controversial.this study is a systemic review of available evidence.Methods: Searching multiple domestic and overseas databases to collect the randomized controlled trial(RCT)and nonrandomized controlled trial(NRCT)about anatomic liver resection and conventional liver resection from 2000 to October2015.The quality of the included trials was assessed according to the inclusive and exclusive criteria,and the data were collected and analyzed by using Rev Man 5.3software.Results: 11 NRCT including 2284 patients.1196 patients were in the AR group and 1088 patients were in the NAR group.The study has shown that there was significant differences in overall survival between the two groups at 3years[OR=1.63,95%CI(1.28,2.07),P<0.0001] and 5 years [OR=1.48,95%CI(1.23,1.79),P<0.0001],and in disease-free survival at 1 year[OR=1.47,95%CI(1.14,1.89),P=0.003],3 years[OR=1.60,95%CI(1.31,1.96),P<0.00001] and 5 years[OR=1.88,95%CI(1.55,2.28),P<0.00001];anatomic hepatectomy group reduces the early recurrence[OR=0.56,95%CI(0.37,0.83),P=0.004],The rate of postoperative mortality and postoperative morbidity had no significant difference between the two groups.Conclusion: For the patients with Child Pugh A,anatomic liver resection for small hepatocellular carcinoma has a better efficacy than nonanatomic resection.