Hepatectomy for huge hepatocellular carcinoma in 634 cases.
OBJECTIVE
To clarify the safety and feasibility of hepatectomy for huge hepatocellular carcinoma (HCC).


METHODS
A total of 4765 patients with HCC operated at Tongji Hospital were retrospectively studied, of them, 780 patients had huge HCC (10 cm or more in diameter). Hepatectomy was carried out on 634 patients (81.2%). The majority of the liver resection were major resections, and combined resection of the adjacent organs or structures was common (17.2%). The liver resection was combined with portal vein thrombectomy in 139 patients (21.9%).


RESULTS
Postoperative complications were common (26.8%) and required another laparotomy to prevent the complications in 5 patients (0.8%). The 30-d mortality was 2.2%. The main causes of postoperative deaths were liver failure (n = 9), postoperative bleeding (n = 4) and septic complication (n = 1). The 3-, 5- and 10-year survival rates after liver resection were 35.1%, 18.2% and 3.5%, respectively.


CONCLUSIONS
Hepatectomy for huge HCC is safe and effective. It should be used to treat patients with low surgical risks and resectable tumours.
Chen
Xiao-Ping
XP
Hepatic Surgery Center, Tongji Hospital, Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China. chenxp_53@sina.com
Qiu
Fa-Zu
FZ
Wu
Zai-De
ZD
Zhang
Bi-Xiang
BX
D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015994:Incidence; D008099:Liver / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016019:Survival Analysis