Background: In patients with solitary hepatocellular carcinoma ≤5 cm without macrovascular invasion, it is unknown whether the initial anatomic resection improves the long-term survival.
Methods: Among 545 initial hepatectomies for hepatocellular carcinoma between 2000 and 2012, the 233 patients with the aforementioned criteria of hepatocellular carcinoma were enrolled.
Results: The mean observation time was 1,125 days. Disease-free 5-year survival rates with and without anatomic resection were 46% and 23%, respectively (P = .009). Multivariate analyses for disease-free survival rates revealed the risk factors to be α-fetoprotein (odds ratio, 1.6; P = .028) and anatomic resection (odds ratio, .7; P = .048), while increased Child-Pugh score (>5) was the only independent risk factor for overall survival (odds ratio, 1.8; P = .043). The 5-year overall survival rates with and without Child-Pugh score 5 were 74% and 40%, respectively (P < .0001, log-rank test).
Conclusions: Initial anatomic resection for small solitary hepatocellular carcinoma without macrovascular invasion improved disease-free survival rates remarkably.
Keywords: Anatomic resection; Liver dysfunction; Long-term prognosis; Milan criteria; Small hepatocellular carcinoma; Solitary hepatocellular carcinoma.
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