Encapsulation is a significant prognostic factor for better outcome in large hepatocellular carcinoma

Authors

  • Tsung-Han Wu MD,

    1. Department of General Surgery, Chang Gung Memorial Hospital, Linkou, Chang Gung University Medical School, Taoyuan, Taiwan
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  • Ming-Chin Yu MD,

    Corresponding author
    1. Department of General Surgery, Chang Gung Memorial Hospital, Linkou, Chang Gung University Medical School, Taoyuan, Taiwan
    2. Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
    • Department of Surgery, Chang Gung Memorial Hospital, Linkou 5, Fu-Hsing Street, Kweishan, Taoyuan, Taiwan. Fax: +886-3-3285818.===

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  • Tse-Ching Chen MD, PhD,

    1. Department of Pathology, Chang Gung Memorial Hospital, Chang Gung University Medical School, Taoyuan, Taiwan
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  • Chen-Fang Lee MD,

    1. Department of General Surgery, Chang Gung Memorial Hospital, Linkou, Chang Gung University Medical School, Taoyuan, Taiwan
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  • Kun-Ming Chan MD,

    1. Department of General Surgery, Chang Gung Memorial Hospital, Linkou, Chang Gung University Medical School, Taoyuan, Taiwan
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  • Ting-Jung Wu MD,

    1. Department of General Surgery, Chang Gung Memorial Hospital, Linkou, Chang Gung University Medical School, Taoyuan, Taiwan
    2. Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
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  • Hong-Shiue Chou MD,

    1. Department of General Surgery, Chang Gung Memorial Hospital, Linkou, Chang Gung University Medical School, Taoyuan, Taiwan
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  • Wei-Chen Lee MD,

    1. Department of General Surgery, Chang Gung Memorial Hospital, Linkou, Chang Gung University Medical School, Taoyuan, Taiwan
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  • Miin-Fu Chen MD

    1. Department of General Surgery, Chang Gung Memorial Hospital, Linkou, Chang Gung University Medical School, Taoyuan, Taiwan
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  • Ming-Chin Yu and Tsung-Han Wu contributed equally to this study.

Abstract

Background

The aim of this study was to determine the effect of tumor encapsulation of hepatocellular carcinoma (HCC) on long-term survival.

Methods

A retrospective review of 1,240 patients who underwent hepatectomy from January 1993 to June 2005 was conducted. There were 891 patients with tumor encapsulation (EC type) and 349 patients without tumor encapsulation (NC type). Clinicopathological factors, surgical outcome, and long-term survival were analyzed.

Results

Disease-free survival (DFS) was affected by surgical margin involvement, the presence of surgical complications, vascular invasion, liver cirrhosis, tumor encapsulation, tumor size >5 cm, tumor rupture, and the presence of satellite lesions (all, P < 0.05). Overall survival (OS) was also affected by the same parameters, except for satellite lesions. When the patients were grouped by tumor size >5 or ≤5 cm, the protective effect of encapsulation was only observed when the tumor size was >5 cm [odds ratio (OR) for DFS = 0.75, P = 0.02; OR for OS = 0.68, P < 0.01].

Conclusions

Tumor encapsulation is a significant prognostic factor for HCC >5 cm. J. Surg. Oncol. 2012; 105:85–90. © 2011 Wiley Periodicals, Inc.

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