Background/aim: This study aimed to clarify the efficacy of anatomical hepatectomy in patients with preserved liver function.
Patients and methods: We compared the clinicopathology of the anatomical hepatectomy (AH) group (n=264) with that of the non-anatomical hepatectomy (NAH) group (n=85) and evaluated favorable conditions of anatomical hepatectomy for patients with HCC with an indocyanine green 15-minute retention rate of less than 30%.
Results: There was no significant difference between the two groups in five-year disease-free survival. However, disease-free survival of the AH group was significantly better than that of the NAH group when patients had T1 tumors, tumors without intrahepatic metastasis, tumors located within one subsegment, or serum alpha feto-protein less than 100 ng/dl (p=0.015, p=0.009, p=0.046 and p=0.036, respectively). Anatomical hepatectomy was an independent favorable prognostic factor by multivariate analysis taking into consideration clinical factors, which could be clarified pre- or intraoperatively (p=0.003).
Conclusion: Anatomical hepatectomy should be performed for HCC patients with HCC with preserved liver function.