{"title":"肝细胞癌解剖性肝脏切除术对预防术后早期局部复发的影响。","authors":"Akira Shimizu, Koji Kubota, Tsuyoshi Notake, Noriyuki Kitagawa, Hitoshi Masuo, Takahiro Yoshizawa, Hiroki Sakai, Hikaru Hayashi, Shiori Yamazaki, Yuji Soejima","doi":"10.1002/jhbp.12004","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The superiority of anatomical liver resection (AR) for localized hepatocellular carcinoma (HCC) over nonanatomical liver resection (NR) remains controversial. This study aimed to investigate the impact of AR in preventing local and early HCC recurrence.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A total of 280 patients who underwent initial liver resection for solitary HCC ≤5 cm in diameter were categorized into the AR and NR groups and compared using propensity score matching analysis.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Between the matched pairs (<i>n</i> = 87 in each group), the incidence rates of local and early (recurrence within 2 years after surgery) recurrences in the AR group were significantly lower than those in the NR group (13.8% vs. 28.7%, <i>p</i> = .025; 20.7% vs. 35.6%, <i>p</i> = .028, respectively). The overall survival in the AR group was better than that in the NR group (median: 13.4 vs. 7.6 years, <i>p</i> = .003). NR was among independent risk factors for early recurrence (odds ratio: 1.98, 95% CI: 1.1–3.6, <i>p</i> = .023) and prognostic factors for local recurrence (hazard ratio: 2.44, 95% CI: 1.4–4.4, <i>p</i> = .003).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>AR is superior in controlling local and early recurrence postoperatively for solitary HCC ≤5 cm in diameter compared with NR.</p>\n </section>\n </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":null,"pages":null},"PeriodicalIF":3.2000,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhbp.12004","citationCount":"0","resultStr":"{\"title\":\"Impact of anatomical liver resection for hepatocellular carcinoma in preventing early-phase local recurrence after surgery\",\"authors\":\"Akira Shimizu, Koji Kubota, Tsuyoshi Notake, Noriyuki Kitagawa, Hitoshi Masuo, Takahiro Yoshizawa, Hiroki Sakai, Hikaru Hayashi, Shiori Yamazaki, Yuji Soejima\",\"doi\":\"10.1002/jhbp.12004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>The superiority of anatomical liver resection (AR) for localized hepatocellular carcinoma (HCC) over nonanatomical liver resection (NR) remains controversial. This study aimed to investigate the impact of AR in preventing local and early HCC recurrence.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A total of 280 patients who underwent initial liver resection for solitary HCC ≤5 cm in diameter were categorized into the AR and NR groups and compared using propensity score matching analysis.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Between the matched pairs (<i>n</i> = 87 in each group), the incidence rates of local and early (recurrence within 2 years after surgery) recurrences in the AR group were significantly lower than those in the NR group (13.8% vs. 28.7%, <i>p</i> = .025; 20.7% vs. 35.6%, <i>p</i> = .028, respectively). The overall survival in the AR group was better than that in the NR group (median: 13.4 vs. 7.6 years, <i>p</i> = .003). NR was among independent risk factors for early recurrence (odds ratio: 1.98, 95% CI: 1.1–3.6, <i>p</i> = .023) and prognostic factors for local recurrence (hazard ratio: 2.44, 95% CI: 1.4–4.4, <i>p</i> = .003).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>AR is superior in controlling local and early recurrence postoperatively for solitary HCC ≤5 cm in diameter compared with NR.</p>\\n </section>\\n </div>\",\"PeriodicalId\":16056,\"journal\":{\"name\":\"Journal of Hepato‐Biliary‐Pancreatic Sciences\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2024-05-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhbp.12004\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hepato‐Biliary‐Pancreatic Sciences\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/jhbp.12004\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hepato‐Biliary‐Pancreatic Sciences","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/jhbp.12004","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：解剖性肝切除术（AR）治疗局部肝细胞癌（HCC）优于非解剖性肝切除术（NR）仍存在争议。本研究旨在探讨AR对预防局部和早期HCC复发的影响：方法：将280例因单发HCC直径≤5厘米而接受初次肝切除术的患者分为AR组和NR组，并采用倾向评分匹配分析法进行比较：结果：在配对组（每组87人）中，AR组的局部复发率和早期复发率（术后2年内复发）明显低于NR组（分别为13.8% vs. 28.7%，p = .025；20.7% vs. 35.6%，p = .028）。AR组的总生存期优于NR组（中位数：13.4年对7.6年，P = .003）。NR是早期复发的独立危险因素（几率比：1.98，95% CI：1.1-3.6，p = .023）和局部复发的预后因素（危险比：2.44，95% CI：1.4-4.4，p = .003）：结论：与NR相比，AR在控制直径≤5厘米的单发HCC术后局部和早期复发方面更具优势。
Impact of anatomical liver resection for hepatocellular carcinoma in preventing early-phase local recurrence after surgery
Background
The superiority of anatomical liver resection (AR) for localized hepatocellular carcinoma (HCC) over nonanatomical liver resection (NR) remains controversial. This study aimed to investigate the impact of AR in preventing local and early HCC recurrence.
Methods
A total of 280 patients who underwent initial liver resection for solitary HCC ≤5 cm in diameter were categorized into the AR and NR groups and compared using propensity score matching analysis.
Results
Between the matched pairs (n = 87 in each group), the incidence rates of local and early (recurrence within 2 years after surgery) recurrences in the AR group were significantly lower than those in the NR group (13.8% vs. 28.7%, p = .025; 20.7% vs. 35.6%, p = .028, respectively). The overall survival in the AR group was better than that in the NR group (median: 13.4 vs. 7.6 years, p = .003). NR was among independent risk factors for early recurrence (odds ratio: 1.98, 95% CI: 1.1–3.6, p = .023) and prognostic factors for local recurrence (hazard ratio: 2.44, 95% CI: 1.4–4.4, p = .003).
Conclusion
AR is superior in controlling local and early recurrence postoperatively for solitary HCC ≤5 cm in diameter compared with NR.
期刊介绍：
The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.
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