Anatomical versus non‐anatomical resection for solitary hepatocellular carcinoma without macroscopic vascular invasion: A propensity score matching analysis
Background and Aim The superiority of anatomical resection (AR) in patients with hepatocellular carcinoma compared with non‐anatomical resection (NAR) remains controversial. We aimed to investigate the prognostic outcomes of AR and NAR for solitary hepatocellular carcinoma (HCC) patients without mac...
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| Veröffentlicht in: | Journal of gastroenterology and hepatology 2017-04, Vol.32 (4), p.870-878 |
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| creator | Zhao, Hui Chen, Chuang Gu, Shen Yan, Xiaopeng Jia, Wenjun Mao, Liang Qiu, Yudong |
| description | Background and Aim
The superiority of anatomical resection (AR) in patients with hepatocellular carcinoma compared with non‐anatomical resection (NAR) remains controversial. We aimed to investigate the prognostic outcomes of AR and NAR for solitary hepatocellular carcinoma (HCC) patients without macroscopic vascular invasion, using a propensity score matching (PSM) analysis.
Methods
A total of 305 consecutive HCC patients without macroscopic vascular invasion who underwent curative hepatectomy were included in our study. PSM was performed in order to eliminate possible selection bias.
Results
By PSM, the patients were divided into propensity‐matched anatomical resection (PS‐AR) (n = 114) and propensity‐matched non‐anatomical resection (PS‐NAR) (n = 114) groups. The 1‐year, 3‐year, and 5‐year overall survival rates were 90.4%, 77.7%, and 65.7% in PS‐AR and 88.6%, 70.7%, and 52.2% in PS‐NAR (P = 0.053), respectively. The 1‐year, 3‐year, and 5‐year recurrence‐free survival (RFS) rates were 84.1%, 64.9%, and 45.1% in PS‐AR and 75.4%, 48.1%, and 31.0% in PS‐NAR (P = 0.005), respectively. Multivariate analysis showed that ICG‐R15 (P = 0.022); the Barcelona clinic liver cancer staging (P = 0.044) and microvascular invasion (MVI; P = 0.005) were independent risk factors for the overall survival rate, while type of resection (P = 0.027), surgical margin (P = 0.039), and MVI (P = 0.024) were independent risk factors for the RFS rate. Patients who underwent NAR were prone to early recurrence and marginal recurrence. Subgroup analysis indicated that the RFS rate was significantly better in PS‐AR than that in PS‐NAR (surgical margin ≥ 1 cm) (P = 0.025). Better RFS rate was observed in PS‐AR with MVI compared with PS‐NAR (P = 0.016).
Conclusions
Anatomical resection contributed to improve the RFS rate in solitary HCC patients without macroscopic vascular invasion using PSM analysis, especially in patients with MVI. |
| doi_str_mv | 10.1111/jgh.13603 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1888956117</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1859736887</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4523-8ce9a85d6bbe012b9a606a3c67de490462e3e2c568fb6094dc2f2fc98b1fcfa33</originalsourceid><addsrcrecordid>eNqN0c9qFDEcB_Agit1WD76ABLzoYdr8n8TbUrS1FHrR85DJ_qabZSYZk5mWvfkIPoEP55M0260VBKG5JIRPvskvP4TeUHJMyzjZXK-PKVeEP0MLKgSpaC3Uc7QgmsrKcGoO0GHOG0KIILV8iQ5YrWrKiFmgX8tgpzh4Z3t8AynPGYcYfv_4af_uJ8jgJh8D7mLCOfZ-smmL1zAW4qDv594m7GxyPsTB4ls_reM84cG6FLOLo3f4xmZ3z3woy5L1ES_xmOIIIftpiwtLUE5Mbu3DNS6399vs8yv0orN9htcP8xH69vnT19Pz6vLq7Mvp8rJyQjJeaQfGarlSbQuEstZYRZTlTtUrEIYIxYADc1LprlXEiJVjHeuc0S3tXGc5P0Lv97nlSd9nyFMz-LwrzQaIc26o1tpIRWn9BCpNzZXWO_ruH7qJcyqlFWUYEVpKLov6sFe738oJumZMfig_3FDS7PrblP429_0t9u1D4twOsHqUfxpawMke3Poetv9Pai7OzveRdxgRtGY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1920485535</pqid></control><display><type>article</type><title>Anatomical versus non‐anatomical resection for solitary hepatocellular carcinoma without macroscopic vascular invasion: A propensity score matching analysis</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Zhao, Hui ; Chen, Chuang ; Gu, Shen ; Yan, Xiaopeng ; Jia, Wenjun ; Mao, Liang ; Qiu, Yudong</creator><creatorcontrib>Zhao, Hui ; Chen, Chuang ; Gu, Shen ; Yan, Xiaopeng ; Jia, Wenjun ; Mao, Liang ; Qiu, Yudong</creatorcontrib><description>Background and Aim
The superiority of anatomical resection (AR) in patients with hepatocellular carcinoma compared with non‐anatomical resection (NAR) remains controversial. We aimed to investigate the prognostic outcomes of AR and NAR for solitary hepatocellular carcinoma (HCC) patients without macroscopic vascular invasion, using a propensity score matching (PSM) analysis.
Methods
A total of 305 consecutive HCC patients without macroscopic vascular invasion who underwent curative hepatectomy were included in our study. PSM was performed in order to eliminate possible selection bias.
Results
By PSM, the patients were divided into propensity‐matched anatomical resection (PS‐AR) (n = 114) and propensity‐matched non‐anatomical resection (PS‐NAR) (n = 114) groups. The 1‐year, 3‐year, and 5‐year overall survival rates were 90.4%, 77.7%, and 65.7% in PS‐AR and 88.6%, 70.7%, and 52.2% in PS‐NAR (P = 0.053), respectively. The 1‐year, 3‐year, and 5‐year recurrence‐free survival (RFS) rates were 84.1%, 64.9%, and 45.1% in PS‐AR and 75.4%, 48.1%, and 31.0% in PS‐NAR (P = 0.005), respectively. Multivariate analysis showed that ICG‐R15 (P = 0.022); the Barcelona clinic liver cancer staging (P = 0.044) and microvascular invasion (MVI; P = 0.005) were independent risk factors for the overall survival rate, while type of resection (P = 0.027), surgical margin (P = 0.039), and MVI (P = 0.024) were independent risk factors for the RFS rate. Patients who underwent NAR were prone to early recurrence and marginal recurrence. Subgroup analysis indicated that the RFS rate was significantly better in PS‐AR than that in PS‐NAR (surgical margin ≥ 1 cm) (P = 0.025). Better RFS rate was observed in PS‐AR with MVI compared with PS‐NAR (P = 0.016).
Conclusions
Anatomical resection contributed to improve the RFS rate in solitary HCC patients without macroscopic vascular invasion using PSM analysis, especially in patients with MVI.</description><identifier>ISSN: 0815-9319</identifier><identifier>EISSN: 1440-1746</identifier><identifier>DOI: 10.1111/jgh.13603</identifier><identifier>PMID: 27671209</identifier><language>eng</language><publisher>Australia: Wiley Subscription Services, Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; anatomical hepatectomy ; Carcinoma, Hepatocellular - mortality ; Carcinoma, Hepatocellular - pathology ; Carcinoma, Hepatocellular - surgery ; Disease-Free Survival ; Female ; Hepatectomy ; Hepatectomy - methods ; Hepatocellular carcinoma ; Humans ; Liver cancer ; Liver Neoplasms - mortality ; Liver Neoplasms - pathology ; Liver Neoplasms - surgery ; Male ; microvascular invasion ; Microvasculature ; Middle Aged ; Multivariate analysis ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Neoplasm Staging ; non‐anatomical hepatectomy ; Propensity Score ; propensity score matching analysis ; Risk Factors ; Survival ; Survival Rate ; Time Factors ; Young Adult</subject><ispartof>Journal of gastroenterology and hepatology, 2017-04, Vol.32 (4), p.870-878</ispartof><rights>2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd</rights><rights>2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.</rights><rights>2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4523-8ce9a85d6bbe012b9a606a3c67de490462e3e2c568fb6094dc2f2fc98b1fcfa33</citedby><cites>FETCH-LOGICAL-c4523-8ce9a85d6bbe012b9a606a3c67de490462e3e2c568fb6094dc2f2fc98b1fcfa33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjgh.13603$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjgh.13603$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27671209$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhao, Hui</creatorcontrib><creatorcontrib>Chen, Chuang</creatorcontrib><creatorcontrib>Gu, Shen</creatorcontrib><creatorcontrib>Yan, Xiaopeng</creatorcontrib><creatorcontrib>Jia, Wenjun</creatorcontrib><creatorcontrib>Mao, Liang</creatorcontrib><creatorcontrib>Qiu, Yudong</creatorcontrib><title>Anatomical versus non‐anatomical resection for solitary hepatocellular carcinoma without macroscopic vascular invasion: A propensity score matching analysis</title><title>Journal of gastroenterology and hepatology</title><addtitle>J Gastroenterol Hepatol</addtitle><description>Background and Aim
The superiority of anatomical resection (AR) in patients with hepatocellular carcinoma compared with non‐anatomical resection (NAR) remains controversial. We aimed to investigate the prognostic outcomes of AR and NAR for solitary hepatocellular carcinoma (HCC) patients without macroscopic vascular invasion, using a propensity score matching (PSM) analysis.
Methods
A total of 305 consecutive HCC patients without macroscopic vascular invasion who underwent curative hepatectomy were included in our study. PSM was performed in order to eliminate possible selection bias.
Results
By PSM, the patients were divided into propensity‐matched anatomical resection (PS‐AR) (n = 114) and propensity‐matched non‐anatomical resection (PS‐NAR) (n = 114) groups. The 1‐year, 3‐year, and 5‐year overall survival rates were 90.4%, 77.7%, and 65.7% in PS‐AR and 88.6%, 70.7%, and 52.2% in PS‐NAR (P = 0.053), respectively. The 1‐year, 3‐year, and 5‐year recurrence‐free survival (RFS) rates were 84.1%, 64.9%, and 45.1% in PS‐AR and 75.4%, 48.1%, and 31.0% in PS‐NAR (P = 0.005), respectively. Multivariate analysis showed that ICG‐R15 (P = 0.022); the Barcelona clinic liver cancer staging (P = 0.044) and microvascular invasion (MVI; P = 0.005) were independent risk factors for the overall survival rate, while type of resection (P = 0.027), surgical margin (P = 0.039), and MVI (P = 0.024) were independent risk factors for the RFS rate. Patients who underwent NAR were prone to early recurrence and marginal recurrence. Subgroup analysis indicated that the RFS rate was significantly better in PS‐AR than that in PS‐NAR (surgical margin ≥ 1 cm) (P = 0.025). Better RFS rate was observed in PS‐AR with MVI compared with PS‐NAR (P = 0.016).
Conclusions
Anatomical resection contributed to improve the RFS rate in solitary HCC patients without macroscopic vascular invasion using PSM analysis, especially in patients with MVI.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>anatomical hepatectomy</subject><subject>Carcinoma, Hepatocellular - mortality</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Hepatectomy</subject><subject>Hepatectomy - methods</subject><subject>Hepatocellular carcinoma</subject><subject>Humans</subject><subject>Liver cancer</subject><subject>Liver Neoplasms - mortality</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - surgery</subject><subject>Male</subject><subject>microvascular invasion</subject><subject>Microvasculature</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Neoplasm Invasiveness</subject><subject>Neoplasm Recurrence, Local</subject><subject>Neoplasm Staging</subject><subject>non‐anatomical hepatectomy</subject><subject>Propensity Score</subject><subject>propensity score matching analysis</subject><subject>Risk Factors</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>Time Factors</subject><subject>Young Adult</subject><issn>0815-9319</issn><issn>1440-1746</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqN0c9qFDEcB_Agit1WD76ABLzoYdr8n8TbUrS1FHrR85DJ_qabZSYZk5mWvfkIPoEP55M0260VBKG5JIRPvskvP4TeUHJMyzjZXK-PKVeEP0MLKgSpaC3Uc7QgmsrKcGoO0GHOG0KIILV8iQ5YrWrKiFmgX8tgpzh4Z3t8AynPGYcYfv_4af_uJ8jgJh8D7mLCOfZ-smmL1zAW4qDv594m7GxyPsTB4ls_reM84cG6FLOLo3f4xmZ3z3woy5L1ES_xmOIIIftpiwtLUE5Mbu3DNS6399vs8yv0orN9htcP8xH69vnT19Pz6vLq7Mvp8rJyQjJeaQfGarlSbQuEstZYRZTlTtUrEIYIxYADc1LprlXEiJVjHeuc0S3tXGc5P0Lv97nlSd9nyFMz-LwrzQaIc26o1tpIRWn9BCpNzZXWO_ruH7qJcyqlFWUYEVpKLov6sFe738oJumZMfig_3FDS7PrblP429_0t9u1D4twOsHqUfxpawMke3Poetv9Pai7OzveRdxgRtGY</recordid><startdate>201704</startdate><enddate>201704</enddate><creator>Zhao, Hui</creator><creator>Chen, Chuang</creator><creator>Gu, Shen</creator><creator>Yan, Xiaopeng</creator><creator>Jia, Wenjun</creator><creator>Mao, Liang</creator><creator>Qiu, Yudong</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>201704</creationdate><title>Anatomical versus non‐anatomical resection for solitary hepatocellular carcinoma without macroscopic vascular invasion: A propensity score matching analysis</title><author>Zhao, Hui ; Chen, Chuang ; Gu, Shen ; Yan, Xiaopeng ; Jia, Wenjun ; Mao, Liang ; Qiu, Yudong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4523-8ce9a85d6bbe012b9a606a3c67de490462e3e2c568fb6094dc2f2fc98b1fcfa33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>anatomical hepatectomy</topic><topic>Carcinoma, Hepatocellular - mortality</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Hepatectomy</topic><topic>Hepatectomy - methods</topic><topic>Hepatocellular carcinoma</topic><topic>Humans</topic><topic>Liver cancer</topic><topic>Liver Neoplasms - mortality</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - surgery</topic><topic>Male</topic><topic>microvascular invasion</topic><topic>Microvasculature</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Neoplasm Invasiveness</topic><topic>Neoplasm Recurrence, Local</topic><topic>Neoplasm Staging</topic><topic>non‐anatomical hepatectomy</topic><topic>Propensity Score</topic><topic>propensity score matching analysis</topic><topic>Risk Factors</topic><topic>Survival</topic><topic>Survival Rate</topic><topic>Time Factors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhao, Hui</creatorcontrib><creatorcontrib>Chen, Chuang</creatorcontrib><creatorcontrib>Gu, Shen</creatorcontrib><creatorcontrib>Yan, Xiaopeng</creatorcontrib><creatorcontrib>Jia, Wenjun</creatorcontrib><creatorcontrib>Mao, Liang</creatorcontrib><creatorcontrib>Qiu, Yudong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastroenterology and hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhao, Hui</au><au>Chen, Chuang</au><au>Gu, Shen</au><au>Yan, Xiaopeng</au><au>Jia, Wenjun</au><au>Mao, Liang</au><au>Qiu, Yudong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anatomical versus non‐anatomical resection for solitary hepatocellular carcinoma without macroscopic vascular invasion: A propensity score matching analysis</atitle><jtitle>Journal of gastroenterology and hepatology</jtitle><addtitle>J Gastroenterol Hepatol</addtitle><date>2017-04</date><risdate>2017</risdate><volume>32</volume><issue>4</issue><spage>870</spage><epage>878</epage><pages>870-878</pages><issn>0815-9319</issn><eissn>1440-1746</eissn><abstract>Background and Aim
The superiority of anatomical resection (AR) in patients with hepatocellular carcinoma compared with non‐anatomical resection (NAR) remains controversial. We aimed to investigate the prognostic outcomes of AR and NAR for solitary hepatocellular carcinoma (HCC) patients without macroscopic vascular invasion, using a propensity score matching (PSM) analysis.
Methods
A total of 305 consecutive HCC patients without macroscopic vascular invasion who underwent curative hepatectomy were included in our study. PSM was performed in order to eliminate possible selection bias.
Results
By PSM, the patients were divided into propensity‐matched anatomical resection (PS‐AR) (n = 114) and propensity‐matched non‐anatomical resection (PS‐NAR) (n = 114) groups. The 1‐year, 3‐year, and 5‐year overall survival rates were 90.4%, 77.7%, and 65.7% in PS‐AR and 88.6%, 70.7%, and 52.2% in PS‐NAR (P = 0.053), respectively. The 1‐year, 3‐year, and 5‐year recurrence‐free survival (RFS) rates were 84.1%, 64.9%, and 45.1% in PS‐AR and 75.4%, 48.1%, and 31.0% in PS‐NAR (P = 0.005), respectively. Multivariate analysis showed that ICG‐R15 (P = 0.022); the Barcelona clinic liver cancer staging (P = 0.044) and microvascular invasion (MVI; P = 0.005) were independent risk factors for the overall survival rate, while type of resection (P = 0.027), surgical margin (P = 0.039), and MVI (P = 0.024) were independent risk factors for the RFS rate. Patients who underwent NAR were prone to early recurrence and marginal recurrence. Subgroup analysis indicated that the RFS rate was significantly better in PS‐AR than that in PS‐NAR (surgical margin ≥ 1 cm) (P = 0.025). Better RFS rate was observed in PS‐AR with MVI compared with PS‐NAR (P = 0.016).
Conclusions
Anatomical resection contributed to improve the RFS rate in solitary HCC patients without macroscopic vascular invasion using PSM analysis, especially in patients with MVI.</abstract><cop>Australia</cop><pub>Wiley Subscription Services, Inc</pub><pmid>27671209</pmid><doi>10.1111/jgh.13603</doi><tpages>9</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over anatomical hepatectomy Carcinoma, Hepatocellular - mortality Carcinoma, Hepatocellular - pathology Carcinoma, Hepatocellular - surgery Disease-Free Survival Female Hepatectomy Hepatectomy - methods Hepatocellular carcinoma Humans Liver cancer Liver Neoplasms - mortality Liver Neoplasms - pathology Liver Neoplasms - surgery Male microvascular invasion Microvasculature Middle Aged Multivariate analysis Neoplasm Invasiveness Neoplasm Recurrence, Local Neoplasm Staging non‐anatomical hepatectomy Propensity Score propensity score matching analysis Risk Factors Survival Survival Rate Time Factors Young Adult |
| title | Anatomical versus non‐anatomical resection for solitary hepatocellular carcinoma without macroscopic vascular invasion: A propensity score matching analysis |
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