Anatomic versus nonanatomic hepatectomy for a solitary hepatocellular carcinoma : a case-controlled study with propensity score matching.

BACKGROUND: It remains controversial whether anatomical resection (AR) improves the prognosis for hepatocellular carcinoma (HCC) or not. To our knowledge, there have been a few well-matched studies about this issue. The aim of the present study was to compare the recurrence-free survival of AR versus nonanatomical resection (NAR) for a solitary HCC using propensity score matching.

METHODS: The present study included 236 patients who had a solitary HCC without macroscopic vessel thrombosis. Those patients were divided into AR (n = 139) and NAR (n = 97) groups. A propensity score matching was performed to minimize the effect of potential confounders.

RESULTS: Sixty-four patients from each group were matched. Preoperative confounding factors were balanced between the two groups. The median recurrence-free survival times in the AR and NAR groups were 33.8 and 30.8 months, respectively (P = 0.520). There were no significant differences in the intrahepatic recurrence pattern (P = 0.097). Operative procedure was not a significant risk factor for recurrence in both uni- and multivariate analyses.

CONCLUSIONS: This case-matching study using a propensity score shows that there is no superiority of AR to NAR relevant to the recurrence-free survival in patients with a single HCC.