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Subsegmentectomy or segmentectomy in hepatocellular carcinoma

S Miyagawa1, S Kawasaki

  • 1First Department of Surgery, Shinshu University, School of Medicine, Matsumoto, Japan.

Hepato-Gastroenterology
|March 13, 1998
PubMed
Summary
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For hepatocellular carcinoma (HCC), initial subsegmentectomy or segmentectomy improves survival. Repeated hepatectomy with transcatheter arterial embolization (TAE) offers long-term survival for recurrent cases.

Area of Science:

  • Hepatobiliary Surgery
  • Surgical Oncology
  • Gastroenterology

Background:

  • Hepatocellular carcinoma (HCC) presents a significant challenge in cancer treatment.
  • Optimizing surgical strategies is crucial for improving patient survival rates.

Purpose of the Study:

  • To determine the optimal therapeutic strategy for improving survival in HCC patients.
  • To analyze surgical outcomes and recurrence patterns in HCC.

Main Methods:

  • Analysis of 205 patients undergoing curative hepatectomy between 1990-1996.
  • Resection volume determined by indocyanine green retention; ultrasonographic guidance used for precise dissection.
  • Comparison of limited resection, subsegmentectomy/segmentectomy, and lobectomy/extended lobectomy.

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Main Results:

  • Disease-free survival rates were 65% at 1 year, 35.1% at 3 years, and 25.3% at 5 years.
  • Subsegmental or segmental resection significantly improved cumulative and disease-free survival compared to limited resection (p=0.047, p<0.01).
  • Repeated hepatectomy combined with transcatheter arterial embolization (TAE) led to significantly longer survival post-recurrence than TAE alone (p=0.0197).

Conclusions:

  • Initial subsegmentectomy or segmentectomy is associated with prolonged disease-free survival in HCC patients.
  • Patients undergoing repeated hepatectomy with TAE after recurrence demonstrate potential for long-term survival.
  • Wider application of subsegmentectomy or segmentectomy is recommended to enhance overall HCC survival rates.