Longterm Favorable Results of Limited Hepatic Resections for Patients with Hepatocellular Carcinoma: 20 Years of Experience

Yo ichi Yamashita, Akinobu Taketomi, shinji itoh, Dai Kitagawa, Hiroto Kayashima, Norifumi Harimoto, Eiji Tsujita, Yohsuke Kuroda, Yoshihiko Maehara

Research output: Contribution to journalArticle

105 Citations (Scopus)

Abstract

Background: Recently, anatomic resection has been, in theory, considered preferable for eradicating portal venous tumor extension and intrahepatic metastasis in hepatocellular carcinoma (HCC). We have reported the effectiveness of limited hepatic resection for cirrhotic patients with HCC. Study Design: A retrospective study was carried out in 321 patients who underwent curative hepatic resection (anatomic resection, n = 201; limited resection, n = 120) as the initial treatment for solitary HCC < 5 cm in our institution in the period 1985 to 2004 (median followup period 5.1 years). Results: Anatomic resection did not influence overall and recurrence-free survival rates after hepatic resection. In the liver damage A group (n = 215), both 5-year overall and recurrence-free survival rates in the anatomic resection group were considerably better than those in the limited resection group (87% versus 76%, p = 0.02, and 63% versus 35%, p < 0.01, respectively). In the liver damage B group (n = 106), both 5-year overall and recurrence-free survival rates in the anatomic resection group were substantially worse than those in the limited resection group (48% versus 72%, p < 0.01, and 28% versus 43%, p = 0.01, respectively). The results of multivariate analysis revealed that anatomic resection was a notably poor factor in promoting recurrence-free survival in patients with liver damage B. Conclusions: Anatomic resection should be recommended for noncirrhotic patients (liver damage A) with HCC. Longterm results of limited hepatic resection proved its validity for cirrhotic patients (liver damage B) with HCC.

Original languageEnglish
Pages (from-to)19-26
Number of pages8
JournalJournal of the American College of Surgeons
Volume205
Issue number1
DOIs
Publication statusPublished - Jul 1 2007

Fingerprint

Hepatocellular Carcinoma
Liver
Recurrence
Survival Rate
Multivariate Analysis
Retrospective Studies
Neoplasm Metastasis
Survival
Neoplasms

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Longterm Favorable Results of Limited Hepatic Resections for Patients with Hepatocellular Carcinoma : 20 Years of Experience. / Yamashita, Yo ichi; Taketomi, Akinobu; itoh, shinji; Kitagawa, Dai; Kayashima, Hiroto; Harimoto, Norifumi; Tsujita, Eiji; Kuroda, Yohsuke; Maehara, Yoshihiko.

In: Journal of the American College of Surgeons, Vol. 205, No. 1, 01.07.2007, p. 19-26.

Research output: Contribution to journalArticle

Yamashita, Yo ichi ; Taketomi, Akinobu ; itoh, shinji ; Kitagawa, Dai ; Kayashima, Hiroto ; Harimoto, Norifumi ; Tsujita, Eiji ; Kuroda, Yohsuke ; Maehara, Yoshihiko. / Longterm Favorable Results of Limited Hepatic Resections for Patients with Hepatocellular Carcinoma : 20 Years of Experience. In: Journal of the American College of Surgeons. 2007 ; Vol. 205, No. 1. pp. 19-26.
@article{b71ca694fb12488f8c1fc4a17779bd05,
title = "Longterm Favorable Results of Limited Hepatic Resections for Patients with Hepatocellular Carcinoma: 20 Years of Experience",
abstract = "Background: Recently, anatomic resection has been, in theory, considered preferable for eradicating portal venous tumor extension and intrahepatic metastasis in hepatocellular carcinoma (HCC). We have reported the effectiveness of limited hepatic resection for cirrhotic patients with HCC. Study Design: A retrospective study was carried out in 321 patients who underwent curative hepatic resection (anatomic resection, n = 201; limited resection, n = 120) as the initial treatment for solitary HCC < 5 cm in our institution in the period 1985 to 2004 (median followup period 5.1 years). Results: Anatomic resection did not influence overall and recurrence-free survival rates after hepatic resection. In the liver damage A group (n = 215), both 5-year overall and recurrence-free survival rates in the anatomic resection group were considerably better than those in the limited resection group (87{\%} versus 76{\%}, p = 0.02, and 63{\%} versus 35{\%}, p < 0.01, respectively). In the liver damage B group (n = 106), both 5-year overall and recurrence-free survival rates in the anatomic resection group were substantially worse than those in the limited resection group (48{\%} versus 72{\%}, p < 0.01, and 28{\%} versus 43{\%}, p = 0.01, respectively). The results of multivariate analysis revealed that anatomic resection was a notably poor factor in promoting recurrence-free survival in patients with liver damage B. Conclusions: Anatomic resection should be recommended for noncirrhotic patients (liver damage A) with HCC. Longterm results of limited hepatic resection proved its validity for cirrhotic patients (liver damage B) with HCC.",
author = "Yamashita, {Yo ichi} and Akinobu Taketomi and shinji itoh and Dai Kitagawa and Hiroto Kayashima and Norifumi Harimoto and Eiji Tsujita and Yohsuke Kuroda and Yoshihiko Maehara",
year = "2007",
month = "7",
day = "1",
doi = "10.1016/j.jamcollsurg.2007.01.069",
language = "English",
volume = "205",
pages = "19--26",
journal = "Journal of the American College of Surgeons",
issn = "1072-7515",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Longterm Favorable Results of Limited Hepatic Resections for Patients with Hepatocellular Carcinoma

T2 - 20 Years of Experience

AU - Yamashita, Yo ichi

AU - Taketomi, Akinobu

AU - itoh, shinji

AU - Kitagawa, Dai

AU - Kayashima, Hiroto

AU - Harimoto, Norifumi

AU - Tsujita, Eiji

AU - Kuroda, Yohsuke

AU - Maehara, Yoshihiko

PY - 2007/7/1

Y1 - 2007/7/1

N2 - Background: Recently, anatomic resection has been, in theory, considered preferable for eradicating portal venous tumor extension and intrahepatic metastasis in hepatocellular carcinoma (HCC). We have reported the effectiveness of limited hepatic resection for cirrhotic patients with HCC. Study Design: A retrospective study was carried out in 321 patients who underwent curative hepatic resection (anatomic resection, n = 201; limited resection, n = 120) as the initial treatment for solitary HCC < 5 cm in our institution in the period 1985 to 2004 (median followup period 5.1 years). Results: Anatomic resection did not influence overall and recurrence-free survival rates after hepatic resection. In the liver damage A group (n = 215), both 5-year overall and recurrence-free survival rates in the anatomic resection group were considerably better than those in the limited resection group (87% versus 76%, p = 0.02, and 63% versus 35%, p < 0.01, respectively). In the liver damage B group (n = 106), both 5-year overall and recurrence-free survival rates in the anatomic resection group were substantially worse than those in the limited resection group (48% versus 72%, p < 0.01, and 28% versus 43%, p = 0.01, respectively). The results of multivariate analysis revealed that anatomic resection was a notably poor factor in promoting recurrence-free survival in patients with liver damage B. Conclusions: Anatomic resection should be recommended for noncirrhotic patients (liver damage A) with HCC. Longterm results of limited hepatic resection proved its validity for cirrhotic patients (liver damage B) with HCC.

AB - Background: Recently, anatomic resection has been, in theory, considered preferable for eradicating portal venous tumor extension and intrahepatic metastasis in hepatocellular carcinoma (HCC). We have reported the effectiveness of limited hepatic resection for cirrhotic patients with HCC. Study Design: A retrospective study was carried out in 321 patients who underwent curative hepatic resection (anatomic resection, n = 201; limited resection, n = 120) as the initial treatment for solitary HCC < 5 cm in our institution in the period 1985 to 2004 (median followup period 5.1 years). Results: Anatomic resection did not influence overall and recurrence-free survival rates after hepatic resection. In the liver damage A group (n = 215), both 5-year overall and recurrence-free survival rates in the anatomic resection group were considerably better than those in the limited resection group (87% versus 76%, p = 0.02, and 63% versus 35%, p < 0.01, respectively). In the liver damage B group (n = 106), both 5-year overall and recurrence-free survival rates in the anatomic resection group were substantially worse than those in the limited resection group (48% versus 72%, p < 0.01, and 28% versus 43%, p = 0.01, respectively). The results of multivariate analysis revealed that anatomic resection was a notably poor factor in promoting recurrence-free survival in patients with liver damage B. Conclusions: Anatomic resection should be recommended for noncirrhotic patients (liver damage A) with HCC. Longterm results of limited hepatic resection proved its validity for cirrhotic patients (liver damage B) with HCC.

UR - http://www.scopus.com/inward/record.url?scp=34347329243&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34347329243&partnerID=8YFLogxK

U2 - 10.1016/j.jamcollsurg.2007.01.069

DO - 10.1016/j.jamcollsurg.2007.01.069

M3 - Article

C2 - 17617328

AN - SCOPUS:34347329243

VL - 205

SP - 19

EP - 26

JO - Journal of the American College of Surgeons

JF - Journal of the American College of Surgeons

SN - 1072-7515

IS - 1

ER -