Anatomic versus Non-Anatomic Liver Resection for Hepatocellular Carcinoma: A Systematic Review

 Yun-Hao Tang, Tian-Fu Wen, Xi Chen
ABSTRACT
Background/Aims: To evaluate the feasibility and
therapeutic effects of anatomic liver resection versus
non-anatomic liver resection for hepatocellular carcinoma.
Methodology: Randomized controlled trials
and non-randomized trials comparing the clinical effectiveness
between anatomic and non-anatomic liver
resection for hepatocellular carcinoma were identified
by using a predefined search strategy. A meta-analysis
was performed to estimate pooled survival and recurrence
rate. Results: No Randomized controlled trial
was identified. Twelve non-randomized comparative
trials (10 in English and 2 in Chinese) including total
1,829 cases, 1,005 cases in anatomic resection group
and 824 cases in non-anatomic resection group, were
included in this review. Meta-analysis showed that
there was no significant difference between anatomic
and non-anatomic liver resection in 1-year survival
rate (p = 0.98), 3-year survival rate (p = 0.75), 5-year
survival rate (p = 0.38) and recurrence rate (p = 0.44).
The differences in post-operative morbidity (p = 0.32)
and blood loss during operation (p = 0.11) were also
not statistically significant. Conclusions: Anatomic liver
resection for HCC does not provide significant benefit
in 1-year/3-year/5-year survival rate, recurrence
rate, post-operative morbidity and blood loss during
operation compared with non-anatomic resection.
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