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Central Hepatectomy Versus Major Hepatectomy for Centrally Located Hepatocellular Carcinoma : A Propensity Score Matching Study

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Title: Central Hepatectomy Versus Major Hepatectomy for Centrally Located Hepatocellular Carcinoma : A Propensity Score Matching Study
Authors: Orimo, Tatsuya Browse this author →KAKEN DB
Kamiyama, Toshiya Browse this author
Kakisaka, Tatsuhiko Browse this author
Shimada, Shingo Browse this author
Nagatsu, Akihisa Browse this author
Asahi, Yoh Browse this author
Sakamoto, Yuzuru Browse this author
Kamachi, Hirofumi Browse this author
Taketomi, Akinobu Browse this author →KAKEN DB
Issue Date: 1-Oct-2021
Publisher: Springer
Journal Title: Annals of surgical oncology
Volume: 28
Start Page: 6769
End Page: 6779
Publisher DOI: 10.1245/s10434-021-09751-z
Abstract: Background In terms of anatomical liver sectionectomy approaches, both a central hepatectomy (CH) and major hepatectomy (MH) are feasible options for a centrally located hepatocellular carcinoma (HCC). Methods We retrospectively reviewed the surgical outcomes of central HCC patients who underwent CH or MH. MH includes hemihepatectomy or trisectionectomy, whereas CH involves a left medial sectionectomy, right anterior sectionectomy, or central bisectionectomy. The surgical outcomes were compared before and after propensity score matching (PSM). Results A total of 233 patients were enrolled, including 132 in the CH group and 101 in the MH group. The MH group cases were pathologically more advanced and had poorer overall survival rates than the CH group. After PSM, 68 patients were selected into each group, both of which showed similar overall and recurrence-free survival outcomes. The CH group showed a tendency for a longer operation time; however, other perioperative outcomes were similar between the two groups. Multivariate analyses of our matched HCC patients revealed that the type of surgery (CH or MH) was not an independent prognostic factor. More patients in the matched CH group experienced a repeat hepatectomy for recurrence and no patients in this group underwent a preoperative portal vein embolization. Conclusions The short- and long-term surgical outcomes of CH and MH for a centrally located HCC are similar under a matched clinicopathological background. CH has the advantage of not requiring a preoperative portal vein embolization and increased chances of conducting a repeat hepatectomy for recurrence.
Rights: This is a post-peer-review, pre-copyedit version of an article published in Annals of Surgical Oncology. The final authenticated version is available online at:
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 折茂 達也

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