Anatomic versus non-anatomic resection for hepatocellular carcinoma: A systematic review and meta-analysis

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
Dimitrios MorisTimothy M Pawlik

Abstract

The relative benefit of anatomic resection (AR) versus non-anatomic resection (NAR) of HCC remains poorly defined. We sought to evaluate the available evidence on oncologic outcomes, as well as the clinical efficacy and safety of AR versus NAR performed as the primary treatment for HCC patients. A systematic review and meta-analysis was conducted using Medline, ClinicalTrials.gov and Cochrane library through April 15th, 2017. Only clinical studies comparing AR versus NAR were deemed eligible. A total of 43 studies were considered eligible (total 12,429 patients: AR, n = 6839 (55%) versus NAR, n = 5590 (45%)). Blood loss was higher among patients undergoing AR (mean difference: +229.74 ml, 95% CI: 97.09-362.38, p = 0.0007), whereas resection margin was slightly wider following AR versus NAR (mean difference: +0.29 cm, 95% CI: 0.15-0.44, p < 0.0001). No difference was noted for perioperative complications (RR: 0.95, 95% CI: 0.81-1.11, p = 0.49) and perioperative mortality (RR: 0.91, 95% CI: 0.43-1.95, p = 0.82). AR was associated with a disease-free survival (DFS) benefit at 1- (HR: 0.79, 95% CI: 0.68-0.92, p = 0.002), 3- (HR: 0.87, 95% CI: 0.78-0.95, p = 0.004) and 5-years (HR: 0.87, 95% CI: 0.82-0.93, p < 0.0001). AR also was a...Continue Reading

Citations

Sep 5, 2019·Journal of Gastroenterology and Hepatology·Sung Whan ChaSoon Koo Baik
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Aug 19, 2021·Langenbeck's Archives of Surgery·Nikolaos MachairasTimothy M Pawlik

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