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Am J Surg. 2009 Nov;198(5):693-701. doi: 10.1016/j.amjsurg.2008.09.019. Epub 2009 Mar 6.

Outcome after curative resection for a huge (>or=10 cm) hepatocellular carcinoma and prognostic significance of gross tumor classification.

Author information

1
Department of Surgery, Yonsei University Health System, Seoul 120-752, Korea.

Abstract

BACKGROUND AND OBJECTIVES:

The purpose of this study was to investigate the surgical outcomes in patients with huge (>or=10 cm) hepatocellular carcinoma (HCC).

METHODS:

Clinicopathological features and surgical outcomes of 50 patients with huge HCC who underwent curative resection (group A) were compared with 447 patients with smaller tumors (group B). In group A, we investigated prognostic factors.

RESULTS:

Group A patients had a higher incidence of alpha-fetoprotein at more than 1,000 IU/mL, microscopic vascular invasion, and advanced stage tumors. The disease-free survival of group A was significantly worse than group B. The rates of initial extrahepatic recurrence and early recurrence were higher in group A. The 5 year-overall survival of group A was 40.2%, significantly lower than that of group B (65.9% at 5 years). In group A, multivariate analysis revealed that the presence of single nodular type tumors was the only good prognostic factor for survival.

CONCLUSIONS:

Huge HCCs exhibit a more aggressive clinical behavior and worse survival. However, because the outcome of surgical treatment is far better than that of nonsurgical treatment, resection should be actively considered for patients with huge HCC. A single nodular type tumor is the best candidate for surgical resection.

PMID:
19268907
DOI:
10.1016/j.amjsurg.2008.09.019
[Indexed for MEDLINE]

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