Surgical treatment and outcome in patients with a hepatocellular carcinoma greater than 10 cm in diameter

Background Hepatocellular carcinoma (HCC) over 10 cm in diameter at the time of diagnosis continues to account for a number of patients undergoing hepatic resection. This study evaluated the clinicopathological features and outcome following surgery for large HCC. Methods Forty patients with a large...

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Published in:	British journal of surgery Vol. 85; no. 12; pp. 1654 - 1657
Main Authors:	Lee, N. H., Chau, G. Y., Lui, W. Y., King, K. L.s, Tsay, S. H., Wu, C. W.
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Science Ltd 01-12-1998 Wiley
Subjects:	Adult Aged Aged, 80 and over Biological and medical sciences Blood Loss, Surgical Carcinoma, Hepatocellular - pathology Carcinoma, Hepatocellular - surgery Disease-Free Survival Female Gastroenterology. Liver. Pancreas. Abdomen Hospital Mortality Humans Liver Neoplasms - pathology Liver Neoplasms - surgery Liver. Biliary tract. Portal circulation. Exocrine pancreas Male Medical sciences Middle Aged Neoplasm Recurrence, Local Retrospective Studies Survival Analysis Treatment Outcome Tumors Human Carcinoma Liver Size Hepatic disease Surgical resection Malignant tumor Long term Survival Treatment Surgery Digestive diseases Comparative study
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Summary:	Background Hepatocellular carcinoma (HCC) over 10 cm in diameter at the time of diagnosis continues to account for a number of patients undergoing hepatic resection. This study evaluated the clinicopathological features and outcome following surgery for large HCC. Methods Forty patients with a large HCC (greater than 10 cm) (group 1) resected between 1991 and 1996 were studied retrospectively. They were compared with 245 patients who had smaller HCCs (10 cm or less) (group 2). Results No patient in group 1 had hepatitis C infection compared with 22·9 per cent in group 2 (P =0·001). Patients in group 1 were significantly younger, had higher α‐fetoprotein levels (16 750 versus 1864 ng/ml; P < 0·001), better liver function, a higher incidence of multiple tumours (27 of 40 versus 42·0 per cent; P =0·003) and venous invasion (35 of 40 versus 52·2 per cent; P < 0·001), and underwent more major resections (37 of 40 versus 26·5 per cent; P < 0·001) than those in group 2. Morbidity and mortality rates and hospital stay were comparable in the two groups. For group 1, the 1‐, 3‐ and 5‐year disease‐free survival rates were 42, 30 and 28 per cent respectively. Multiple tumours, venous invasion and impaired liver function were factors associated with recurrence. Conclusion Large HCC had specific clinicopathological features. In selected patients, resection is safe and offers the chance of long‐term disease‐free survival. © 1998 British Journal of Surgery Society Ltd.
Bibliography:	istex:CFA68FEAF2DFE192C9946CFE57533C3F96E4C09F ark:/67375/WNG-P8HTMM1H-L ArticleID:BJS11 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0007-1323 1365-2168
DOI:	10.1046/j.1365-2168.1998.00918.x