Evaluation of Anatomical Hepatectomy for Large Hepatocellular Carcinoma Associated with Cirrhosis

Objective:To evaluate the safety and efficacy of the anatomical hepatectomy for large hepatocellular carcinoma(HCC)associated with cirrhosis.Methods:A total of 239 patients with large hepatocellular carcinoma were divided into anatomical hepatectomy group(n=148)and non-anatomical hepatectomy group(control group,n=91)according to different resection methods.Perioperative parameters and prognosis were investigated between the two groups.Results:The duration of anatomical hepatectomy group was longer than that of control group as(221±58)min vs(187±64)min,P0.001.However,there were significant differences in blood loss during surgery([450±216]ml vs[822±525]ml,P0.001),length of hospital stay after hepatectomy([15±4]d vs[17±4]d;P0.001),postoperative serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBIL)([102±57]U/L vs[193±48]U/L,[80±39]U/Lvs[117±34]U/L,[42.7±21.4]μmol/Lvs[65.5±20.2]μmol/L,respectively;P0.001]between the two groups.There was a significant difference in incidence of postoperative complications between the two groups(anatomical:17.6%,control:23.1%;P0.001).The 3,6,12-month survival rates were 88.7%,77.4%and 66.0%in anatomical hepatectomy group,respectively,while,86.8%,73.6%and 63.1%in control group,with no significant difference(P0.05).Conclusion:The results suggest that anatomical hepatectomy is safe and effective as a treatment for large HCC patients associated with cirrhosis when the patients preserved liver function are well.