The Outcome after Curative Resection for a Huge (> or = 10cm) Hepatocellular Carcinoma.
- Author:
Chang Hee KIM
1
;
Gi Hong CHOI
;
Dai Hoon HAN
;
Dong Hyun KIM
;
Sae Byeol CHOI
;
Chang Moo KANG
;
Kyung Sik KIM
;
Jin Sub CHOI
;
Young Nyun PARK
;
Jun Yong PARK
;
Do Yong KIM
;
Kwang Hyub HAN
;
Chae Yoon CHON
;
Woo Jung LEE
Author Information
1. Department of Surgery, Yonsei University Health System, Seoul, Korea. Choi5491@yuhs.ac
- Publication Type:Original Article
- Keywords:
Hugh Hepatocellular carcinoma;
Surgical Resection;
Prognosis;
Gross Tumor Type
- MeSH:
Carcinoma, Hepatocellular;
Hepatitis B virus;
Humans;
Liver Cirrhosis;
Liver Diseases;
Male;
Multivariate Analysis;
Prognosis;
Survival Rate
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
2008;12(4):238-244
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Recent studies have reported improved perioperative and long-term outcomes for the initial postoperative results for patients with a huge HCC. The purpose of this study was to investigate the surgical outcomes of patients with a huge HCC and we wanted to identify any subgroup that would likely benefit from hepatic resection. METHODS: From January 1996 to August 2006, 55 patients were diagnosed with a huge HCC (> or = 10cm in diameter). All the tumors were classified as either the expanding nodular type or the non- expanding nodular type. RESULTS: The mean age of the patients was 50.6 years and 39 patients were male. The most common cause of liver disease was hepatitis B virus. The mean size of tumor was 11.9 cm. Microscopic liver cirrhosis was present in 17 patients. Twenty-three patients had tumors of the expanding nodular type. Curative resection was performed in 50 patients. The 5-year diseasefree and overall survival rates after resection were 35.8% and 41.0%, respectively. Univariate analysis revealed that surgical margins of < or = 1.0, a non-curative resection, the non-expanding nodular type and microscopic vascular invasion were adverse prognostic factors for survival. Multivariate analysis indicated that the gross tumor classification (expanding nodular vs. nonexpanding nodular) was the only independent prognostic factor. CONCLUSIONS: Huge HCC is not a homogenous group and the gross tumor pattern may represent the biologic behavior of huge HCC. Because the outcome of surgical treatment is far better than that of non-surgical treatment, resection should be actively considered for patients with a huge HCC. An expanding nodular type tumor is the best candidate for surgical resection.
