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Impact of Anatomical Resection on Non-transplantable Recurrence Among Patients with Hepatocellular Carcinoma: An International Multicenter Inverse Probability of Treatment Weighting Analysis.

2025-09Text Open access
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dc.contributor.authorKawashima, Jun
dc.contributor.authorEndo, Yutaka
dc.contributor.authorKhalil, Mujtaba
dc.contributor.authorWoldesenbet, Selamawit
dc.contributor.authorAkabane, Miho
dc.contributor.authorRuzzenente, Andrea
dc.contributor.authorRatti, Francesca
dc.contributor.authorMarques, Hugo
dc.contributor.authorOliveira, Sara
dc.contributor.authorBalaia, Jorge
dc.contributor.authorCauchy, François
dc.contributor.authorLam, Vincent
dc.contributor.authorPoultsides, George
dc.contributor.authorKitago, Minoru
dc.contributor.authorPopescu, Irinel
dc.contributor.authorMartel, Guillaume
dc.contributor.authorGleisner, Ana
dc.contributor.authorHugh, Thomas J
dc.contributor.authorAldrighetti, Luca
dc.contributor.authorEndo, Itaru
dc.contributor.authorPawlik, Timothy M
dc.date.accessioned2025-08-26T12:11:37Z
dc.date.available2025-08-26T12:11:37Z
dc.date.issued2025-09
dc.description.abstractBackground: Among patients with hepatocellular carcinoma (HCC), the impact of anatomic resection (AR) versus non-anatomic resection (NAR) on non-transplantable recurrence (NTR) remains poorly defined. We sought to compare the risk of NTR among patients treated with AR versus NAR as the primary surgical strategy for HCC. Patients and methods: Patients with HCC within Milan criteria who underwent curative-intent resection between 2000 and 2020 were identified from an international multi-institutional database. The inverse probability of treatment weighting (IPTW) method was utilized to compare short- and long-term outcomes among patients undergoing AR versus NAR. Results: Among 1038 patients, 747 (72.0%) patients underwent AR, while 291 (28.0%) patients underwent NAR. After IPTW adjustment, patients who underwent AR had better 5-year recurrence-free survival than individuals treated with NAR (63.9 vs. 52.0%; hazard ratio [HR] 0.78; 95% confidence interval [CI] 0.62-0.99); however, there was no difference in 5-year overall survival (80.2 vs. 75.6%; HR 0.76; 95% CI 0.55-1.05). Notably, individuals who underwent AR were less likely to have a NTR versus individuals treated with NAR (3-year NTR 9.8 vs. 14.4%; HR 0.62; 95% CI 0.40-0.96). In particular, AR was associated with a lower risk of NTR among patients with a medium tumor burden score (TBS) (HR 0.53; 95% CI 0.28-0.99), while the benefit among patients with a low TBS was less pronounced (HR 0.73; 95% CI 0.40-1.32). Conclusions: AR was associated with a lower risk of NTR and improved recurrence-free survival (RFS) among patients with HCC, especially individuals with higher TBS. An anatomically defined surgical approach should be strongly considered in patients with a higher HCC tumor burden.por
dc.identifier.citationAnn Surg Oncol . 2025 Sep;32(9):6243-6253
dc.identifier.doi10.1245/s10434-025-17349-y
dc.identifier.other40323550
dc.identifier.urihttp://hdl.handle.net/10400.17/5145
dc.language.isoen
dc.peerreviewedyes
dc.publisherSpringerLink
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectAged
dc.subjectCarcinoma
dc.subjectHepatocellular* / mortality
dc.subjectHepatocellular* / pathology
dc.subjectHepatocellular* / surgery
dc.subjectFollow-Up Studies
dc.subjectHepatectomy* / methods
dc.subjectHepatectomy* / mortality
dc.subjectLiver Neoplasms* / pathology
dc.subjectLiver Neoplasms* / surgery
dc.subjectLiver Transplantation
dc.subjectMiddle Aged
dc.subjectHumans
dc.subjectNeoplasm Recurrence
dc.subjectLocal* / pathology
dc.subjectLocal* / surgery
dc.subjectPrognosis
dc.subjectRetrospective Studies
dc.subjectSurvival Rate
dc.titleImpact of Anatomical Resection on Non-transplantable Recurrence Among Patients with Hepatocellular Carcinoma: An International Multicenter Inverse Probability of Treatment Weighting Analysis.
dc.typetext
dspace.entity.typePublication
oaire.citation.endPage6253
oaire.citation.issue9
oaire.citation.startPage6243
oaire.citation.volume32
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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