Xiaobin Feng1, Yongjie Su2, Shuguo Zheng3, Feng Xia3, Kuansheng Ma3, Jun Yan1, Xiaowu Li3, Wei Tang4, Shuguang Wang3, Ping Bie3, Jiahong Dong5. 1. Hepato-pancreato-biliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China; Institute of hepatobiliary surgery, Southwest Hospital, Third Military Medical University, Chongqing, China. 2. Institute of hepatobiliary surgery, Southwest Hospital, Third Military Medical University, Chongqing, China; Department of Hepatobiliary Surgery, Xiamen University Zhongshan Hospital, Xiamen, China. 3. Institute of hepatobiliary surgery, Southwest Hospital, Third Military Medical University, Chongqing, China. 4. Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 5. Hepato-pancreato-biliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China; Institute of hepatobiliary surgery, Southwest Hospital, Third Military Medical University, Chongqing, China. Electronic address: dongjiahong@tsinghua.edu.cn.
Abstract
BACKGROUND: The aim of this study was to determine the effect of anatomic resection (AR) versus non-anatomic resection (NAR) on recurrence rates in patients with hepatocellular carcinoma (HCC). METHODS:Eligible patients were randomized to AR or NAR from January 2006 to July 2007 at a single center. The primary outcome was the 2-year recurrence-free survival (RFS). Secondary outcomes were postoperative complications, time to first recurrence, 1-, 3-, and 5-year RFS, and overall survival (OS). RESULTS: Fifty-three (51%) and 52 (50%) patients underwent NAR and AR, respectively. A larger proportion of patients achieved margins ≥20 mm in the AR group (52% vs. 30%; P = 0.023). Complications (blood loss, transfusion requirement, and hospital stay) were similar between the two groups. Median follow-up was 33 (range, 2-77) months. Incidence of local recurrence at 2 years was 30% and 59% in the AR and NAR groups, respectively. Median time to first local recurrence in the AR group was significantly longer than in the NAR group (53 vs. 10 months, P = 0.010). There was no difference in overall RFS between the two groups (P = 0.290). DISCUSSION: AR decreased the 2-year local recurrence rate and increased the time to first local recurrence compared to NAR in patients with HCC.
RCT Entities:
BACKGROUND: The aim of this study was to determine the effect of anatomic resection (AR) versus non-anatomic resection (NAR) on recurrence rates in patients with hepatocellular carcinoma (HCC). METHODS: Eligible patients were randomized to AR or NAR from January 2006 to July 2007 at a single center. The primary outcome was the 2-year recurrence-free survival (RFS). Secondary outcomes were postoperative complications, time to first recurrence, 1-, 3-, and 5-year RFS, and overall survival (OS). RESULTS: Fifty-three (51%) and 52 (50%) patients underwent NAR and AR, respectively. A larger proportion of patients achieved margins ≥20 mm in the AR group (52% vs. 30%; P = 0.023). Complications (blood loss, transfusion requirement, and hospital stay) were similar between the two groups. Median follow-up was 33 (range, 2-77) months. Incidence of local recurrence at 2 years was 30% and 59% in the AR and NAR groups, respectively. Median time to first local recurrence in the AR group was significantly longer than in the NAR group (53 vs. 10 months, P = 0.010). There was no difference in overall RFS between the two groups (P = 0.290). DISCUSSION: AR decreased the 2-year local recurrence rate and increased the time to first local recurrence compared to NAR in patients with HCC.