A comprehensive meta-regression analysis on outcome of anatomic resection versus nonanatomic resection for hepatocellular carcinoma

Alessandro Cucchetti, Matteo Cescon, Giorgio Ercolani, Eleonora Bigonzi, Guido Torzilli, Antonio D. Pinna

Research output: Contribution to journalArticle

Abstract

Background. It remains unclear whether hepatectomy for hepatocellular carcinoma should be performed as an anatomic resection (AR) or a nonanatomic resection (NAR). Because no randomized controlled trials are currently available on this topic, a meta-regression analysis was performed on available observational studies to control for confounding variables. Methods. A systematic review of studies published from 1990 to 2011 in the PubMed and Embase databases was performed. Patient and disease-free survival (DFS), postoperative mortality, and morbidity were considered Abstract: outcomes. Results are expressed as relative risk (RR) or weighted mean differences with 95 % of confidence interval. Results. Eighteen observational studies involving 9,036 patients were analyzed: 4,012 were in the AR group and 5,024 in the NAR group. Meta-analysis suggested that AR provided better 5-year patient survival (RR 1.14; P = 0.001) and DFS than NAR (RR 1.38; P = 0.001). However, patients in the NAR group were characterized by a higher prevalence of cirrhosis (RR 1.27; P = 0.010), more advanced hepatic dysfunction (RR 0.90 for Child- Pugh class A; P = 0.001) and smaller tumor size (weighted mean difference 0.36 cm; P

Original languageEnglish
Pages (from-to)3697-3705
Number of pages9
JournalAnnals of Surgical Oncology
Volume19
Issue number12
DOIs
Publication statusPublished - Nov 2012

ASJC Scopus subject areas

  • Surgery
  • Oncology

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