title: Efficacy of major hepatic resection for large hepatocellular carcinoma.
abstract: OBJECTIVE
  A large hepatocellular carcinoma (HCC) generally carries a poor prognosis despite curative hepatic resection. However, some cases have had good outcomes without recurrences. In this study, we investigated the factors which predicted a good prognosis.
  
  
  METHODS
  Sixty-six patients with large HCC greater than 5 cm who underwent curative hepatic resections were divided into two groups. There were 55 patients who had recurrences within 5 years after surgery (group A) and 11 patients who did not have recurrences at the fifth year after surgery (group B). We compared the clinicopathological features between the two groups.
  
  
  RESULTS
  No differences were seen in the pre-operative liver function tests and the incidence of histological cirrhosis. The incidence of positive rate of histological recurrence factors, such as intrahepatic metastasis and incomplete surgical margins, was significantly less in group B. Five (45%) and 10 (91%) of 11 patients in group B underwent pre-operative portal vein embolization and major hepatic resection, respectively, while 10 (18%) and 29 (53%) of 55 patients in group A underwent these procedures (p < 0.05).
  
  
  CONCLUSIONS
  In order to increase tumor-free survival rates for patients with large HCC greater than 5 cm, major hepatic resection after portal vein embolization with complete surgical margins should be performed.
authors.affiliation: Second Department of Surgery, Osaka City University Medical School, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Shuto
authors.forename: K
authors.initials: K
authors.lastname: Hirohashi
authors.forename: S
authors.initials: S
authors.lastname: Kubo
authors.forename: H
authors.initials: H
authors.lastname: Tanaka
authors.forename: T
authors.initials: T
authors.lastname: Yamamoto
authors.forename: T
authors.initials: T
authors.lastname: Ikebe
authors.forename: H
authors.initials: H
authors.lastname: Kinoshita
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D004621:Embolization, Therapeutic; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D011169:Portal Vein; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome