Surgical resection is the primary form of curative treatment for hepatocellular carcinoma. Recent reports suggested that when compared to non-anatomical resection, anatomical liver resection improved prognosis of HCC patients. Whether anatomical liver resection should be the preferred routine procedure remains controversial.

The data of 236 HCC patients who underwent curative hepatectomy at the PLA General Hospital from January 2008 to July 2013 were reviewed. The data included basic information, procedure, tumor related information and follow-up data. Factors influencing overall survival and tumor-free survival rates were analyzed by multivariate analysis. Multivariate analysis and stratification analysis were also used to evaluate the long-term efficacy of the different procedures.

The 5-year survival rate of anatomical liver resection was 75%, which was significantly better than that of non-anatomical resection (65%) (P<0.05). The tumor-free survival rate was 51%, which was significantly better than that of non-anatomical resection (34%) P<0.05). Antiviral therapy prolonged survival time and tumor-free survival time of HbsAg-positive patients. Surgical procedure, tumor diameter, tumor staging, antiviral therapy were influencing factors of overall survival. Surgical procedure, tumor staging, antiviral therapy were influencing factors of tumor-free survival. Anatomical resection improved the tumor-free survival for patients with tumor diameters less than 5 cm (P=0.098), improved tumor-free survival for patients with TNM stage T1 and T2 (P=0.059), and significantly improved the overall survival and tumor-free survivals for patients with T3, T4 (P<0.05).

Anatomical resection is recommended for treatment of patients with hepatocellular carcinoma.

Anatomical liver resection; Non-anatomical liver resection; 5-year survival; Tumor-free survival