Association of primary hepatocellular carcinoma laterality with oncological outcomes for hepatic resection patients: A retrospective, multicenter, propensity score-matched study

초록

Background & aims: The anatomical location of hepatocellular carcinoma (HCC) represents a fundamental clinical determinant of significance in the context of hepatic resection. However, the prognostic variances and clinical characteristics associated with tumor laterality remain to be definitively established. This retrospective study aimed to investigate the association of primary HCC laterality with oncological outcomes in hepatic resection patients. Methods: Between January 2015 and December 2020, non-cirrhotic patients with a single HCC in one liver lobe underwent hepatic resection for the first time at one of three tertiary medical centers in Republic of Korea. We divided the patients into two groups based on tumor location: the right HCC (rHCC) group and the left HCC (lHCC) group. Survival and risk factor analyses were performed to assess recurrence differences in relation to several other factors. Results: Propensity score matching (PSM) of 1:1 was conducted to establish the rHCC group (n = 521) and the lHCC group (n = 521). The lHCC group experienced a significantly higher rate of HCC recurrence than the rHCC group (25.1 % vs. 17.9 %, p = 0.005). The lHCC group was associated with a significant risk of HCC recurrence after adjusting for other risk factors (hazard ratio (HR) = 1.326, 95 % confidence interval (CI) = 1.058-1.667, p = 0.017). Conclusion: The lHCC group had a higher rate of HCC recurrence than the rHCC group after hepatic resection. The lHCC is a significant preoperative factor predictive of poor oncologic outcome in HCC patients. Lay summary: This study aimed to investigate how the location of hepatocellular carcinoma affects patient outcomes after surgery. We found that patients with hepatocellular carcinoma on the left side of the liver had a higher chance of hepatocellular carcinoma coming back compared to those with cancer on the right side. Therefore, the location of the hepatocellular carcinoma is an important factor in predicting the likelihood of hepatocellular carcinoma recurrence after surgery. (c) 2025 Asian Surgical Association and Taiwan Society of Coloproctology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).

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