Background: The value of anatomical liver sectionectomy for patients with a solitary hepatocellular carcinoma (HCC) from 2 to 5 cm in greatest diameter has not been clarified.
Methods: We retrospectively studied 454 patients with a solitary HCC from 2 to 5 cm in greatest diameter who underwent initial curative hepatectomy from 1991 to 2006. We separated the liver into three segments according to the Glissonean pedicle ramification (Takasaki's liver segments). Takasaki's segment is recognized as a section in the International Hepato-Pancreato-Biliary Association Brisbane 2000 terminology. Outcomes after sectionectomy (n = 143) and partial sectionectomy (n = 311) for patients with a solitary HCC from 2 to 5 cm in greatest diameter were examined.
Results: The 5-year recurrence-free survival rate and survival rate after sectionectomy (42% and 81%, respectively) were significantly better than those after partial sectionectomy (27%: P = 0.0023, and 66%: P = 0.0006, respectively). Multivariate analysis showed sectionectomy to be a significant independent prognostic factor for recurrence-free survival and overall survival in patients with a solitary HCC from 2 to 5 cm in greatest diameter (P = 0.0217, and P = 0.0085, respectively).
Conclusions: Anatomical liver sectionectomy prevents intrahepatic recurrence of HCC and prolongs survival in patients with a solitary HCC from 2 to 5 cm.