A double blinded prospective randomized trial comparing the effect of anatomic versus non-anatomic resection on hepatocellular carcinoma recurrence
2017; Elsevier BV; Volume: 19; Issue: 8 Linguagem: Inglês
10.1016/j.hpb.2017.04.010
ISSN1477-2574
AutoresXiaobin Feng, Yongjie Su, Shuguo Zheng, Feng Xia, Kuansheng Ma, Jun Yan, Xiaowu Li, Wei Tang, Shuguang Wang, Ping Bie, Jiahong Dong,
Tópico(s)Pancreatic and Hepatic Oncology Research
ResumoBackgroundThe aim of this study was to determine the effect of anatomic resection (AR) versus non-anatomic resection (NAR) on recurrence rates in patients with hepatocellular carcinoma (HCC).MethodsEligible patients were randomized to AR or NAR from January 2006 to July 2007 at a single center. The primary outcome was the 2-year recurrence-free survival (RFS). Secondary outcomes were postoperative complications, time to first recurrence, 1-, 3-, and 5-year RFS, and overall survival (OS).ResultsFifty-three (51%) and 52 (50%) patients underwent NAR and AR, respectively. A larger proportion of patients achieved margins ≥20 mm in the AR group (52% vs. 30%; P = 0.023). Complications (blood loss, transfusion requirement, and hospital stay) were similar between the two groups. Median follow-up was 33 (range, 2–77) months. Incidence of local recurrence at 2 years was 30% and 59% in the AR and NAR groups, respectively. Median time to first local recurrence in the AR group was significantly longer than in the NAR group (53 vs. 10 months, P = 0.010). There was no difference in overall RFS between the two groups (P = 0.290).DiscussionAR decreased the 2-year local recurrence rate and increased the time to first local recurrence compared to NAR in patients with HCC.
Referência(s)