Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Recurrence after Anatomic Resection Versus Nonanatomic Resection for Hepatocellular Carcinoma: A Meta-analysis

  • Ye, J.Z. (Guangxi Tumor Institute & Affiliated Tumor Hospital of Guangxi Medical University) ;
  • Miao, Z.G. (Guangxi Tumor Institute & Affiliated Tumor Hospital of Guangxi Medical University) ;
  • Wu, F.X. (Guangxi Tumor Institute & Affiliated Tumor Hospital of Guangxi Medical University) ;
  • Zhao, Y.N. (Department of Hepato-Billiary Surgery, Affiliated Tumor Hospital of Guangxi Medical University) ;
  • Ye, H.H. (Affiliated Minzu Hospital of Guangxi Medical University) ;
  • Li, L.Q. (Affiliated Tumor Hospital of Guangxi Medical University)
  • Published : 2012.05.30
Download PDF
⟨ Previous Next ⟩

Abstract

The impact of anatomic resection (AR) as compared to non-anatomic resection (NAR) for hepatocellular carcinoma (HCC) as a factor for preventing intra-hepatic and local recurrence after the initial surgical procedure remains controversial. A systematic review and meta-analysis of nonrandomized trials comparing anatomic resection with non-anatomic resection for HCC published from 1990 to 2010 in PubMed and Medline, Cochrane Library, Embase, and Science Citation Index were therefore performed. Intra-hepatic recurrence, including early and late, and local recurrence were considered as primary outcomes. As secondary outcomes, 5 year survival and 5 year disease-free survival were considered. Pooled effects were calculated utilizing either fixed effects or random effects models. Eleven non-randomized studies including 1,576 patients were identified and analyzed, with 810 patients in the AR group and 766 in the NAR group. Patients in the AR group were characterized by lower prevalence of cirrhosis, more favorable hepatic function, and larger tumor size and higher prevalence of macrovascular invasion compared with patients in the NAR group. Anatomic resection significantly reduced the risks of local recurrence and achieved a better 5 years disease-free survival. Also, anatomic resection was marginally effective for decreasing the early intra-hepatic recurrence. However, it was not advantageous in preventing late intra-hepatic recurrence compared with non-anatomic resection. No differences were found between AR and NAR with respect to postoperative morbidity, mortality, and hospitalization. Anatomic resection can be recommended as superior to non-anatomic resection in terms of reducing the risks of local recurrence, early intra-hepatic recurrence and achieving a better 5 year disease-free survival in HCC patients.

Keywords

References

  1. Adachi E, Maeda T, Kajiyama K, et al (1996). Factors correlated with portal venous invasion by hepatocellular carcinoma: univariate and multivariate analyses of 232 resected cases without preoperative treatments. Cancer, 77, 2022-31. https://doi.org/10.1002/(SICI)1097-0142(19960515)77:10<2022::AID-CNCR9>3.0.CO;2-S
  2. Bosh FX, Ribes J, Borras J (1999). Epidemiology of primary liver cancer. Semin Liver Dis, 19, 271-85. https://doi.org/10.1055/s-2007-1007117
  3. DerSimonian R, Laird N (1986). Meta-analysis in clinical trials. Control Clin Trials, 7, 177-88. https://doi.org/10.1016/0197-2456(86)90046-2
  4. Eltawil KM, Kidd M, Giovinazzo F, et al (2010). Differentiating the impact of anatomic and non-anatomic liver resection on early recurrence in patients with Hepatocellular Carcinoma. World J Surg Oncol, 8, 43. https://doi.org/10.1186/1477-7819-8-43
  5. Fan ST, Lo CM, Liu CL, et al (1999). Hepatectomy for hepatocellular carcinoma: toward zero hospital deaths. Ann Surg, 229, 322-30. https://doi.org/10.1097/00000658-199903000-00004
  6. Fuster J, Garcia-Valdecasas JC, Grande L, et al (1996). Hepatocellular carcinoma and cirrhosis. Results of surgical treatment in a European series. Ann Surg, 223, 297-302. https://doi.org/10.1097/00000658-199603000-00011
  7. Hasegawa K, Kokudo N, Imamura H, et al (2005). Prognostic impact of anatomic resection for hepatocellular carcinoma. Ann Surg, 242, 252-9. https://doi.org/10.1097/01.sla.0000171307.37401.db
  8. Imamura H, Matsuyama Y, Miyagawa Y, et al (1999). Prognostic significance of anatomical resection and des-gamma-carboxy prothrombin in patients with hepatocellular carcinoma. Br J Surg, 86, 1032-8. https://doi.org/10.1046/j.1365-2168.1999.01185.x
  9. Imamura H, Matsuyama Y, Tanaka E, et al (2003). Risk factors contributing to early and late phase intrahepatic recurrence of hepatocellular carcinoma after hepatectomy. J Hepatol, 38, 200-7.
  10. Kaibori M, Matsui Y, Hijikawa T, et al (2006). Comparison of limited and anatomic hepatic resection for hepatocellular carcinoma with hepatitis C. Surgery, 139, 385-94. https://doi.org/10.1016/j.surg.2005.08.035
  11. Kamangar F, Dores GM, Anderson WF (2006). Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol, 24, 2137-50. https://doi.org/10.1200/JCO.2005.05.2308
  12. Kang CM, Choi GH, Kim DH, et al (2010). Revisiting the Role of Nonantomic Resection of Small (< 4cm) and ingle Hepatocellular Carcinoma in Patients With Well-Preserved Liver Function. J Surg Res, 160, 81-9. https://doi.org/10.1016/j.jss.2009.01.021
  13. Kobayashi A, Miyagawa S, Miwa S, et al (2008). Prognostic impact of anatomical resection on early and late intrahepatic recurrence in patients with hepatocellular carcinoma. J Hepatobiliary Pancreat Surg, 15, 515-21. https://doi.org/10.1007/s00534-007-1293-7
  14. Kosuge T, Makuuchi M, Takayama T, et al (1993). Longterm results after resection of hepatocellular carcinoma: Experience of 480 cases. Hepatogastroenterology, 40, 328-32.
  15. Llovet JM, Burroughs A, Bruix J (2003). Hepatocellular carcinoma. Lancet, 362, 1907-17. https://doi.org/10.1016/S0140-6736(03)14964-1
  16. Llovet JM, Bustamante J, Castells A, et al (1999). Natural history of untreated nonsurgical hepatocellular carcinoma: rationale for the design and evaluation of therapeutic trials. Hepatology, 29, 62-7. https://doi.org/10.1002/hep.510290145
  17. Lui WY, Chau GY, Loong CC, et al (1995). Hepatic segmentectomy for curative resection of primary hepatocellular carcinoma. Arch Surg, 130, 1090-7. https://doi.org/10.1001/archsurg.1995.01430100068014
  18. Makuuchi M, Hasegawa H, Yamazaki S (1985). Ultrasonically guided subsegmentectomy. Surg Gynecol Obstet, 161, 346-50.
  19. Mathurin P, Raynard B, Dharancy S, et al (2003). Meta-analysis: evaluation of adjuvant therapy after curative liver resection of hepatocellular carcinoma. Aliment Pharmacol Ther, 17, 1247-61. https://doi.org/10.1046/j.1365-2036.2003.01580.x
  20. Minagawa M, Makunchi M, Takayama T, et al (2003). Selection criteria for repeat hepatectomy in patients with recurrent hepatocellular carcinoma. Ann Surg, 238, 703-10. https://doi.org/10.1097/01.sla.0000094549.11754.e6
  21. Nakashima T, Kojiro M (1986). Pathologic characteristics of hepatocellular carcinoma. Semin Liver Dis, 6, 259-66. https://doi.org/10.1055/s-2008-1040608
  22. Nanashima A, Sumida Y, Abo T, et al (2008). Comparison of survival between anatomic and non-anatomic liver resection in patients with hepatocellular carcinoma: significance of surgical margin in non-anatomic resection. Acta Chir Belg, 108, 532-7.
  23. Parkin DM, Bray F, Ferlay J, et al (2001). Estimating the world cancer burden: Globocan 2000. Int J Cancer, 94, 153-6. https://doi.org/10.1002/ijc.1440
  24. Park JH, Koh KC, Choi MS, et al (2006). Analysis of risk factors associated with early multinodular recurrences after hepatic resection for hepatocellular carcinoma. Am J Surg, 192, 29-33. https://doi.org/10.1016/j.amjsurg.2005.11.010
  25. Poon RT (2009). Differentiating early and late recurrence after resection for HCC in cirrhotic patients: implications on surveillance, prevention, and treatment strategies. Ann Surg Oncol, 16, 792-4. https://doi.org/10.1245/s10434-009-0330-y
  26. Poon RT, Fan ST, Lo CM, et al (2001). Improving survival results after resection of hepatocellular carcinoma: a prospective study of 377 patients over 10 years. Ann Surg, 234, 63-70. https://doi.org/10.1097/00000658-200107000-00010
  27. Regimbeau JM, Kianmanesh R, Farges O, et al (2002). Extent of liver resection influences the outcome in patients with cirrhosis and small hepatocellular carcinoma. Surgery, 131, 311-7. https://doi.org/10.1067/msy.2002.121892
  28. Sakon M, Nagano H, Nakamori S, et al (2002). Intrahepatic recurrences of hepatocellular carcinoma after hepatectomy: analysis based on tumor hemodynamics. Arch Surg, 137, 94-9. https://doi.org/10.1001/archsurg.137.1.94
  29. Shigeki Arii S, Tanaka Y, Mitsunori N, et al (2010). Surgical strategies for hepatocellular carcinoma with special reference to anatomical hepatic resection and intraoperative contrastenhanced ultrasonography. Oncology, 78, 125-30.
  30. Shirabe K, Kanematsu T, Matsumata T, et al (1991). Factors linked to early recurrence of small hepatocellular carcinoma after hepatectomy: Univariate and multivariate analyses. Hepatology, 14, 802-5. https://doi.org/10.1002/hep.1840140510
  31. Suh KS (2005). Systematic hepatectomy for small hepatocellular carcinoma in Korea. J Hepatobiliary Pancreat Surg, 12, 365-70. https://doi.org/10.1007/s00534-005-1002-3
  32. Takano S, Oishi H, Kono S, et al (2009). Restrospective analysis of type of hepatic resection for fepatocellular carcinoma. Br J Surg, 87, 65-70.
  33. Takayama T, Sekine T, Makuuchi M, et al (2000). Adoptive immunotherapy to lower postsurgical recurrence rates of hepatocellular carcinoma: a randomized trial. Lancet. 356, 802-7. https://doi.org/10.1016/S0140-6736(00)02654-4
  34. Taketomi A, Kitagawa D, Itoh S, et al (2007). Trends in morbidity and mortality after hepatic resection for hepatocellular carcinoma: an institute's experience with 625 patients. J Am Coll Surg, 204, 580-7. https://doi.org/10.1016/j.jamcollsurg.2007.01.035
  35. Tanaka K, Shimada H, Matsumoto C, et al (2008). Anatomic versus Limited nonantomic resection for solitary hepatocellular carcinoma. Surgery, 143, 607-15. https://doi.org/10.1016/j.surg.2008.01.006
  36. Tanaka S, Mogushi K, Yasen M, et al (2009). Surgical contribution to recurrence-free survival in patients with macrovascular-invasion-negative hepatocellular carcinoma. Surgery, 143, 607-15.
  37. Torzilli G, Makuuchi M, Inoue K, et al (1999). No-mortality liver resection for hepatocellular carcinoma in cirrhotic and noncirrhotic patients: Is there a way? A prospective analysis of our approach. Arch Surg, 134, 984-92. https://doi.org/10.1001/archsurg.134.9.984
  38. Vauthey JN, Lauwers GY, Esnaola NF, et al (2002). Simplified staging for hepatocellular carcinoma. J Clin Oncol, 20, 1527-36. https://doi.org/10.1200/JCO.20.6.1527
  39. Wakai T, Shirai Y, Sakata J, et al (2007). Anatomic resection independently improves long-term survival in patients with T1-T2 hepatocellular carcinoma. Ann Surg Oncol, 14, 1356-65. https://doi.org/10.1245/s10434-006-9318-z
  40. Wells GA, Shea B, O'Connell D, et al (2005). The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analysis. Available from http://www.ohri.ca/programs/clinical_epidemiology/oxford/ htm.
  41. Yamashita Y, Taketomi A, Itoh S, et al (2007). Long term favorable results of limited hepatic resections for patients with hepatocellular carcinoma: 20 years of experience. J Am Coll Surg, 205, 19-26. https://doi.org/10.1016/j.jamcollsurg.2007.01.069
  42. Yamazaki O, Mastsuyama M, Horii K, et al (2010). Comparison of the outcomes between anatomical resection and limited resection for single hepatocellular carcinomas no larger than 5 cm in diameter: a single-center study. J Hepatobiliary Pancreat Sci, 17, 349-58. https://doi.org/10.1007/s00534-009-0253-9
  43. Yuki K, Hirohashi S, Sakamoto M, et al (1990). Growth and spread of hepatocellular carcinoma. A review of 240 consecutive autopsy cases. Cancer, 66, 2174-9. https://doi.org/10.1002/1097-0142(19901115)66:10<2174::AID-CNCR2820661022>3.0.CO;2-A
  44. Zhou Y, Sui C, Li B, et al (2010). Repeat hepatectomy for recurrent hepatocellular carcinoma: a local experience and a systematic review. World J Surg Oncol, 8, 55. https://doi.org/10.1186/1477-7819-8-55

Cited by

  1. Association of Type II Diabetes Mellitus with Hepatocellular Carcinoma Occurrence - a Case Control Study from Kathmandu Valley vol.13, pp.10, 2012, https://doi.org/10.7314/APJCP.2012.13.10.5097
  2. Genistein Reinforces the Inhibitory Effect of Cisplatin on Liver Cancer Recurrence and Metastasis after Curative Hepatectomy vol.14, pp.2, 2013, https://doi.org/10.7314/APJCP.2013.14.2.759
  3. Clinical factors that affect the outcomes after anatomical versus non-anatomical resection for hepatocellular carcinoma vol.47, pp.2, 2017, https://doi.org/10.1007/s00595-016-1397-2
  4. Combined percutaneous radiofrequency ablation and ethanol injection versus hepatic resection for 2.1–5.0 cm solitary hepatocellular carcinoma: a retrospective comparative multicentre study vol.28, pp.9, 2018, https://doi.org/10.1007/s00330-018-5371-9