Korean J Hepatobiliary Pancreat Surg.  2011 May;15(2):90-100. 10.14701/kjhbps.2011.15.2.90.

Outcome of Hepatectomy for Huge Hepatocellular Carcinoma

• Jo S

• KMID: 1980947
• DOI: http://doi.org/10.14701/kjhbps.2011.15.2.90

Abstract

PURPOSE
In spite of the recent improved results of hepatectomy for huge hepatocellular carcinomas (HCC), the prognosis of patients with huge HCCs is still poor compared to that of patients with small HCCs. This study was performed to compare the results of hepatectomy between patients with huge HCCs and those with small HCCs, to identify the prognostic factors in patients with huge HCCs, and to determine the preoperative selection criteria.
METHODS
We retrospectively analyzed 51 patients who underwent hepatectomy, between July 1994 and February 2009 at Dankook University Hospital. Patients with HCC> or =10 cm were classified in large (L) group and others were classified in small (S) group. The clinicopathological features, operative procedures, and postoperative outcome were compared between both groups and various prognostic factors were investigated in group L.
RESULTS
Eleven patients were classified in group L. Tumor size, vascular invasion, and tumor stage were higher in group L. Postoperative morbidity was higher in group L, but mortality was not different between the groups. Disease-free survivals were significantly lower in group L than in group S (36.4%, and 24.2% vs. 72.0%, and 44.0% for 1- and 3-year), but overall survival rates were similar in both groups (45.5%, and 15.2% in group L vs. 60.3%, and 41.3% in group S for 3- and 5-year). Presence of satellite nodules was the only prognostic factor in multivariate analysis after surgery for huge HCC.
CONCLUSION
Regardless of tumor size, huge HCCs deserve consideration for surgery in patients with preserved liver function. Furthermore, the effect of surgery could be maximized with appropriate selection criteria, such as huge HCC without satellite nodules.

Keyword

Carcinoma; Hepatocellular; Hepatectomy; Prognosis

MeSH Terms

Carcinoma, Hepatocellular
Disease-Free Survival
Hepatectomy
Humans
Liver
Multivariate Analysis
Patient Selection
Prognosis
Retrospective Studies
Surgical Procedures, Operative
Survival Rate

Figure

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  Fig. 1 Cumulative disease-free survival curves of the two groups.

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  Fig. 2 Cumulative overall survival curves of the two groups.

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