Anatomic versus Non-Anatomic Liver Resection for Hepatocellular Carcinoma: A Systematic Review

Background/Aims: To evaluate the feasibility and therapeutic effects of anatomic liver resection versus non-anatomic liver resection for hepatocellular carcinoma. Methodology: Randomized controlled trials and non-randomized trials comparing the clinical effectiveness between anatomic and-non-anatomic liver resection for hepatocellular carcinoma were identified by using a predefined search strategy A meta-analysis was performed to estimate pooled survival and recurrence rate. Results: No Randomized controlled trial was identified. Twelve non-randomized comparative trials (10 in English and 2 in Chinese) including total 1,829 cases, 1,065 cases in anatomic resection group and 824 cases in non-anatomic resection group, were included in this review. Meta-analysis showed that there was no significant difference between anatomic and non-anatomic liver resection in 1-year survival rate (p = 0.98), 3-year survival rate (p = 0.75), 5-year survival rate (p = 0.38) and recurrence rate (p = 0.44). The differences in post-operative morbidity (p = 0.32) and blood loss during operation (p = 0.11) were also not statistically significant. Conclusions: Anatomic liver resection for HCC does not provide significant benefit in 1-year/3-year/5-year survival rate, recurrence rate, post-operative morbidity and blood loss during operation compared With non-anatomic resection.