Effect of anatomical liver resection for hepatocellular carcinoma: a systematic review and meta-analysis.

ABSTRACT:

Background

Despite retrospective studies comparing anatomical liver resection (AR) and nonanatomical liver resection (NAR), the efficacy and benefits of AR for hepatocellular carcinoma (HCC) remain unclear.

Materials and methods

We systemically reviewed MEDLINE, Embase, and Cochrane Library for propensity score matched (PSM) cohort studies that compared AR and NAR for HCC. Primary outcomes were overall survival (OS) and recurrence-free survival (RFS). Secondary outcomes were recurrence patterns and perioperative outcomes.

Results

Overall, 22 PSM studies (AR, n=2,496; NAR, n=2,590) were included. AR including systemic segmentectomy was superior to NAR regarding the 3- and 5-year OS. AR showed significantly better 1-, 3-, and 5-year RFS than NAR, with low local and multiple intrahepatic recurrence rates. In the subgroup analyses of tumor diameter ≤5 cm and tumors with microscopic spread, the RFS in the AR group was significantly better than that in the NAR group. Patients with cirrhotic liver in the AR group showed comparable 3- and 5-year RFS with the NAR group. Postoperativeoverall complications were comparable between AR and NAR.

Conclusions

This meta-analysis demonstrated that AR showed better OS and RFS with a low local and multiple intra-hepatic recurrence rate than NAR, especially in patients with tumor diameter ≤5 cm and non-cirrhotic liver.

SUBMITTER: Shin SW 

PROVIDER: S-EPMC10498869 | biostudies-literature | 2023 May

REPOSITORIES: biostudies-literature