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Updated: Jan 3, 2026
Laparoscopic Anatomical Liver Segment VII Resection with Liver Parenchymal Transection Following a Priority Approach
Published on: May 23, 2025
Population-level utilization of anatomic resection in early hepatocellular carcinoma (≤5 cm): post-operative, middle-
Fangqiang Wei1, Hui Liu2, Xiao Liang3
1Department of Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, China.
Background:
Most of previous researches on anatomic resection (AR) in early hepatocellular carcinoma (HCC) were conducted in high-volume centres with controversial results. This study aims to provide evidence of the utilization of AR in early HCC at population level.
Methods:
The Surveillance, Epidemiology, and End Results 18 registries database (2004-2015) of the USA was utilized to identify early HCC cases ≤5 cm. Overall survival and cancer-specific survival were both analysed.
Results:
A total of 976 AR and 409 wedge resection (WR) cases were identified. For the post-operative (death within 1 month) and middle-term (death within 3 years) survival, effect of AR was found to be similar to that of WR after adjusting other covariates. However, for the long-term (death within 5 years) survival, the therapeutic effect of AR proved to be superior to that of WR (relative risk (RR) 0.655 for overall survival; RR 0.658 for cancer-specific survival, both P < 0.05). Furthermore, subgroup analyses suggested that patients characterizing as male, tumour size 1-30 mm, vascular invasion and normal alpha-fetoprotein were more likely to benefit from AR in long-term prognosis (all P < 0.05).
Conclusions:
This study suggests that AR, when adopted at population level, is a better choice in comparison with WR in early HCC based on the evidences that it could provide equivalent post-operative, middle-term prognosis and superior long-term survival.
