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Outcome of partial hepatectomy for large (> 10 cm) hepatocellular carcinoma†
Version of Record online: 29 SEP 2005
Copyright © 2005 American Cancer Society
Volume 104, Issue 9, pages 1948–1955, 1 November 2005
How to Cite
Liau, K.-H., Ruo, L., Shia, J., Padela, A., Gonen, M., Jarnagin, W. R., Fong, Y., D'Angelica, M. I., Blumgart, L. H. and DeMatteo, R. P. (2005), Outcome of partial hepatectomy for large (> 10 cm) hepatocellular carcinoma. Cancer, 104: 1948–1955. doi: 10.1002/cncr.21415
Presented in part at the International Hepato-Pancreato-Biliary Association, June 2–6, 2004, Washington, DC.
- Issue online: 17 OCT 2005
- Version of Record online: 29 SEP 2005
- Manuscript Accepted: 3 JUN 2005
- Manuscript Revised: 19 MAY 2005
- Manuscript Received: 13 AUG 2004
- hepatocellular carcinoma;
- large HCC;
Surgical resection for large (> 10 cm) hepatocellular carcinoma (HCC) is believed by many to be ineffective. The objective of the current study was to review the outcome of partial hepatectomy in patients with large HCC.
Between 1985 and 2002, 193 consecutive patients who underwent partial hepatectomy for HCC were identified from a prospective database. The 82 patients with tumors > 10 cm were compared with the remaining 111 patients with ≤ 10 cm tumors. Clinicopathologic features were analyzed and prognostic factors were evaluated by univariate and multivariate analysis.
The 5-year overall survival for patients with large HCC was 33% with a median of 32 months. Patients with ≤ 10 cm tumors had similar survival. Furthermore, there was no significant difference between the groups in operative mortality (2% in large HCC vs. 6%) or recurrence rate. In patients with large HCC, vascular invasion by tumor and intraoperative blood loss > 2 liters predicted overall survival on multivariate analysis.
Partial hepatectomy is safe for patients with large HCC. In selected patients with large tumors, resection achieves similar overall survival and recurrence-free survival to that of patients with smaller tumors. Minimizing intraoperative blood loss appears to be critical for favorable long-term outcome in patients with large HCC. Cancer 2005. © 2005 American Cancer Society.