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Indications and results of resection for hepatocellular carcinoma. Extent of liver resection influences the outcome in patients with cirrhosis and small hepatocellular carcinoma. Regimbeau JM, Kianmanesh R, Farges O, et al. Longterm favorable results of limited hepatic resections for patients with hepatocellular carcinoma: 20 years of experience. Prognostic impact of anatomic resection for hepatocellular carcinoma. Growth and spread of hepatocellular carcinoma: a review of 240 consecutive autopsy cases. Simplified staging for hepatocellular carcinoma. Vauthey JN, Lauwers GY, Esnaola NF, et al. Analysis of risk factors associated with early multinodular recurrences after hepatic resection for hepatocellular carcinoma. Improved diagnostic imaging and interventional therapies prolong survival after resection for hepatocellular carcinoma in cirrhosis: the University of Bologna experience over 10 years. No-mortality liver resection for hepatocellular carcinoma in cirrhotic and non-cirrhotic patients: is there a way? A prospective analysis of our approach. Surveillance of cirrhosis for hepatocellular carcinoma: systematic review and economic analysis. Thompson Coon J, Rogers G, Hewson P, et al. The continuing increase in the incidence of hepatocellular carcinoma in the United States: an update. Patient survival and DFS after AR seem to be superior to NAR because the worse liver function reserve in the NAR group significantly affects prognosis.Įl-Serag HB, Davila JA, Petersen NJ, McGlynn KA. However, patients in the NAR group were characterized by a higher prevalence of cirrhosis (RR 1.27 P = 0.010), more advanced hepatic dysfunction (RR 0.90 for Child-Pugh class A P = 0.001) and smaller tumor size (weighted mean difference 0.36 cm P 0.05 in all cases). Meta-analysis suggested that AR provided better 5-year patient survival (RR 1.14 P = 0.001) and DFS than NAR (RR 1.38 P = 0.001). ResultsĮighteen observational studies involving 9,036 patients were analyzed: 4,012 were in the AR group and 5,024 in the NAR group.
Results are expressed as relative risk (RR) or weighted mean differences with 95 % of confidence interval. Patient and disease-free survival (DFS), postoperative mortality, and morbidity were considered as outcomes.
MethodsĪ systematic review of studies published from 1990 to 2011 in the PubMed and Embase databases was performed. Because no randomized controlled trials are currently available on this topic, a meta-regression analysis was performed on available observational studies to control for confounding variables. It remains unclear whether hepatectomy for hepatocellular carcinoma should be performed as an anatomic resection (AR) or a nonanatomic resection (NAR).
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