Wei Li1, Long Li2, Daniil Minigalin3, Hong Wu4. 1. Department of Liver Surgery and Liver Transplantation Centre, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China. 2. Department of General Surgery, Dingxi People's Hospital/Lanzhou University Second Hospital Dingxi Hospital, Dingxi, Gansu Province, China. 3. Department of General Surgery, Bashkir State Medical University (BSMU), Ufa, 450000, Russia. 4. Department of Liver Surgery and Liver Transplantation Centre, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China. Electronic address: wuhong7801@163.com.
Abstract
BACKGROUND: Both mesohepatectomy (MH) and extended hepatectomy (EH) can be performed for centrally located hepatocellular carcinoma (HCC). In this study, the long-term prognosis of these surgical approaches was assessed in patients with HCC. METHODS: A retrospective review was undertaken of 171 HCC patients who underwent anatomic hepatectomy for centrally located HCC between January 2005 and January 2016 in West China Hospital, Sichuan University. The impact of the surgical methods on prognosis was assessed for these patients by multivariable regression analysis. In addition, the patients in the MH group were matched in a 1:2 ratio with EH controls. RESULTS: In non-adjusted models, patients in the MH group had similar overall survival (OS, p = 0.066) and disease free survival (DFS, p = 0.654) compared to EH patients. After adjusting for all identified confounders, MH patients showed better OS in comparison with patients in the EH group (p = 0.001), while the DFS was similar. In the propensity score-matched (PSM) subset, patients in MH group had better OS (p = 0.033) but similar DFS (p = 0.328) compared to patients in the EH group. CONCLUSION: Anatomic MH can be recommended as a reasonable surgical option in selected patients with centrally located HCC.
BACKGROUND: Both mesohepatectomy (MH) and extended hepatectomy (EH) can be performed for centrally located hepatocellular carcinoma (HCC). In this study, the long-term prognosis of these surgical approaches was assessed in patients with HCC. METHODS: A retrospective review was undertaken of 171 HCC patients who underwent anatomic hepatectomy for centrally located HCC between January 2005 and January 2016 in West China Hospital, Sichuan University. The impact of the surgical methods on prognosis was assessed for these patients by multivariable regression analysis. In addition, the patients in the MH group were matched in a 1:2 ratio with EH controls. RESULTS: In non-adjusted models, patients in the MH group had similar overall survival (OS, p = 0.066) and disease free survival (DFS, p = 0.654) compared to EH patients. After adjusting for all identified confounders, MHpatients showed better OS in comparison with patients in the EH group (p = 0.001), while the DFS was similar. In the propensity score-matched (PSM) subset, patients in MH group had better OS (p = 0.033) but similar DFS (p = 0.328) compared to patients in the EH group. CONCLUSION: Anatomic MH can be recommended as a reasonable surgical option in selected patients with centrally located HCC.