title: Outcomes of hepatic resection for huge hepatocellular carcinoma (≥ 10 cm in diameter).
abstract: BACKGROUND
  The object of the current study was to review the outcomes of hepatic resection for hepatocellular carcinoma (HCC) ≥ 10 cm.
  
  
  METHODS
  Between 1995 and 2007, fifty-three patients with HCC ≥ 10 cm underwent hepatic resection, and clinical data were compared to those of patients with non-surgical treatment (n = 12). Surgical results for HCC ≥ 10 cm were compared to those of patients with HCC < 10 cm (n = 412). The independent poor prognostic factors of the patients with HCC ≥ 10 cm were identified.
  
  
  RESULTS
  Overall survival was significantly better in patients with hepatic resection for HCC ≥ 10 cm than in those with non-surgical treatment (P < 0.01). Survival rates of patients with hepatic resection for HCC ≥ 10 cm were 35% at 5 years. Morbidity and mortality rate were statistically equal. The independent poor prognostic factors of patients with hepatic resection for HCC ≥ 10 cm were revealed: T4 status, macroscopic tumor thrombus in portal vein (VP+), and the use of intra-operative transfusion.
  
  
  CONCLUSIONS
  Hepatic resections for HCC ≥ 10 cm are safe and efficacious. Minimizing intra-operative blood loss and the establishment of an effective systemic treatment for patients with HCC ≥ 10 cm in T4 appear to be critical.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan. yamashi@surg2.med.kyushu-u.ac.jp
authors.forename: Yo-ichi
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.forename: Shinichi
authors.initials: S
authors.lastname: Aishima
authors.forename: Eiji
authors.initials: E
authors.lastname: Tsuijita
authors.forename: Kazutoyo
authors.initials: K
authors.lastname: Morita
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kayashima
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000556:secondary / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000601:surgery; D009367:Neoplasm Staging; D015996:Survival Rate; D016896:Treatment Outcome