Prognosis in patients with small hepatocellular carcinoma: a meta-analysis.

BACKGROUND/AIMS To evaluate the impact of anatomic and non-anatomic liver resection on prognosis of patients with small hepatocellular carcinoma (HCC) using a meta-analysis. METHODOLOGY Literature on anatomic versus non-anatomic liver resection for the treatment of small HCC published in public was retrieved. RESULTS Four non-randomized controlled trials studies were included in this analysis. These studies included a total of 776 patients: 484 treated with anatomic liver resection and 282 treated with non-anatomic resection. No significant differences were found concerning the 1, 3 and 5-year disease-free survival rate between the two groups. There was no significant difference between the two groups when comparing the 1, 3 and 5-year overall survival rate. We use the sensitivity analysis which found anatomic resection could extend the 3-year disease-free survival rate when compared with non-anatomic resection (odds ratio (OR)=0.72, 95% confidence interval (CI): 0.52-0.99, p=0.04). CONCLUSIONS Anatomic liver resection can extend the 3-year disease-free survival rate of patients with small hepatocellular carcinoma. Further randomized controlled trials are needed to define the exact value of anatomic resection and non-anatomic resection for small HCC.