The Impact of Anatomical Resection for Hepatocellular Carcinoma That Meets the Milan Criteria

Background: The aim of this study was to analyze the impact of anatomical resection for hepatocellular carcinoma (HCC) that meets the Milan criteria. Methods: Between 1990 and 2006, 322 consecutive patients with HCC who met the Milan criteria underwent curative resection (R0) and were classified into two groups: Group A (patients with a single HCC, with a tumor diameter of 5 cm or less) and Group B (patients with multiple tumors, no more than three tumor nodules, each with a diameter of 3 cm or less). Patient survival (PS), recurrence-free survival rates (RFS), and risk factors were analyzed. Results: Univariate analysis revealed that in Group A, anatomical resection was the significant factor related to PS, while anatomical resection was that related to RFS. Multivariate analysis showed that in Group A, anatomical resection was a significant favorite factor associated with PS and RFS. Univariate analysis for Group B revealed that anatomical resection was the significant factor related to PS, while that related to RFS was the anatomical resection. Multivariate analysis showed that anatomical resection was a significant favorite factor for only RFS in Group B. Conclusion: Anatomical resection improved the surgical outcome of the patients with HCC which met the Milan criteria. J. Surg. Oncol. 2010;101:54-60. (C) 2009 Wiley-Liss, Inc.