Purpose In this study, we aim to report the efficacy of using
the anterior approach (AA) versus the conventional approach
(CA), in surgical resection for large hepatocellular carcinoma
(HCC) (≥7 cm) of the right hepatic lobe in terms of surgical
and long-term outcomes.
Materials and Methods Between 2000 and 2006, 138 consecutive
patients who underwent hepatic resection with curative
intent for large right lobe HCC ≥7 cm were identified from a
retrospective database. The 40 patients who had AA were
compared with the remaining 98 patients who had CA.
Clinicopathological features and surgical results were analyzed
and prognostic factors were evaluated by multivariate
analysis.
Results There was no significant difference between the two
groups as regards clinical, laboratory, and pathological parameters.
The operative results had shown a comparable proportion
of patients who experienced massive operative blood loss
and postoperative complications in the two groups. The AA
group had a lower recurrence rate (P = 0·015), better diseasefree
survival (DFS) (P = 0·001), and overall survival than the
CA group. Our study identified that AA is a prognostic factor
of both overall survival and disease-free survival for large
HCC ≥7 cm.
Conclusion The AA is a safe and effective technique for right
hepatic resection for large HCC and achieves more advantageous
long survival outcome over the CA.