Clinical Benefits and Problems of +1 Segment Resection as a Surgical Treatment for Hepatocellular Carcinoma (HCC)

Taisuke Morimoto, Shogo Okamoto, Akira Mitsuyoshi, Iwao Ikai, Akira Tanala, Keichiro Mori, Yoshio Yamaoka

Second Department of Surgery, Kyoto University

For the absolute curative resection of hepatocellular carcinoma (HCC), we propose the +1 segment resection, that is, the resection of all fields perfused by the main portal branch that nourishes the tumor bearing segment, even if the simple resection of that segment would seem to obtain a sufficient macroscopic surgical margin. In the most recent analysis of 25 patients who underwent this procedure, no recurrence was noted in the 8 patients who received right lobectomies for tumors located in the posterior segment, or the 10 patients with maximum tumor diameter less than 20 mm. As a result, the 8-year cumulative disease-free survival rate was 74.1% and the 8-year cumulative survival rate was 72.9%, while the 5-year cummulative survival rate of the other 171 cases of curative resection without +1 segment resection was 48% (p<0.01). It should be emphasized that the +1 segment resection should be considered as a surgical modality for the curative resection of HCC even in small tumors less than 20 mm in diameter.

Reprint requests
Taisuke Morimoto Second Department of Surgery, Kyoto University
54-Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606 JAPAN

Accepted
July 6, 1994

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