Anatomy-based Resection or Margin-based Resection for Hepatocellular Carcinoma

Anatomy-based Resection or Margin-based Resection for Hepatocellular Carcinoma: A Randomized Controlled Trial

Anatomical liver resection was widely accepted as first line curative therapy for hepatocellular carcinoma. However, number of retrospective clinical studies showed no priority of anatomical resection for hepatocellular, compared with non-anatomical resection.

Surgical resection margin is a essential factor that may affect tumor prognosis. It is controversial whether adequate liver resection margin is associated with improved survival outcome in patients with hepatocellular.

There was few prospective clinical trial to investigate whether anatomical liver resection is superior to non-anatomical resection or liver resection with adequate margin is superior to that with inadequate margin. This prospective clinical trial aims at fix these issues.

In the anatomical liver resection group, liver segmentectomy or lobectomy is performed to insure curative resection (R0 resection). The region of liver resected is based on the anatomy or portal vein and hepatic vein. The liver pedicle of the tumor located lobe is exposed and dissected, which is principle to perform anatomical liver resection.

In the non-anatomical liver resection group, the liver parenchyma transection is around 0-2 cm from the tumor margin, according to tumor size and location.

Inclusion Criteria:

• patients diagnosed with hepatocellular carcinoma of BCLC stage A
• liver function Child-pugh A
• normal indocyanine green retention rate
• adequate liver remnant

Exclusion Criteria:

• age less than 17 y or older than 65 y
• unresectable liver cancer
• intraoperative ablation
• contraindication for liver resection
• preoperative treatment for hepatocellular
• active hepatitis
• pregnant
• multi-original tumors
• mixed liver cancer (hepatocellular carcinoma and cholangiocellular carcinoma)
• tumor recurrence