ARIIZUMI Shunichi    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Associate Professor
Article types	Original article
Language	English
Peer review	Peer reviewed
Title	Impact of systematic segmentectomy for small hepatocellular carcinoma.
Journal	Formal name：Journal of hepato-biliary-pancreatic sciences Abbreviation：J Hepatobiliary Pancreat Sci ISSN code：18686982/18686974
Volume, Issue, Page	27(6),pp.331-341
Author and coauthor	Kaibori Masaki, Yoshii Kengo, Hasegawa Kiyoshi, Ariizumi Shunichi, Kobayashi Tsuyoshi, Kamiyama Toshiya, Kudo Atsushi, Yamaue Hiroki, Kokudo Norihiro, Yamamoto Masakazu
Publication date	2020/06
Summary	BACKGROUND:We compared survival after resection by systematic segmentectomy (SS) versus non-anatomic resection (NAR) in patients with small, solitary hepatocellular carcinomas (HCCs).METHODS:To control for variables, we used 1-to-1 propensity score matching to compare outcomes after surgery among 615 patients in Japan between 2003 and 2007 with primary solitary HCCs ≤3 cm in diameter who received SS (n = 114) or NAR (n = 114) of one Couinaud segment with complete removal of the portal territory containing the tumor.RESULTS:We successfully matched SS and NAR patients with primary HCC tumors ≤3.0 cm and similar liver function and tumor characteristics. The SS group had significantly longer recurrence-free survival (RFS; hazard ratio [HR] 1.56, 95% confidence interval [CI] 1.10-2.21, P = .013) and overall survival (OS; HR 1.67, 95% CI 1.07-2.60, P = .025) than the NAR group. Among patients who lost >400 mL of blood during surgery, had chronic hepatitis, or had cirrhosis, the RFS and OS were better in the SS group than in the NAR group. In Cox proportional hazard analysis, SS offered a better prognosis than NAR.CONCLUSIONS:Systematic segmentectomy decreases the risk of recurrence and improves OS in patients with primary, solitary HCC tumors of ≤3 cm in diameter.
DOI	10.1002/jhbp.720
PMID	32012448