title: Encapsulation is a significant prognostic factor for better outcome in large hepatocellular carcinoma.
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.
authors.affiliation: Department of General Surgery, Chang Gung Memorial Hospital, Linkou, Chang Gung University Medical School, Taoyuan, Taiwan.
authors.forename: Tsung-Han
authors.initials: TH
authors.lastname: Wu
authors.forename: Ming-Chin
authors.initials: MC
authors.lastname: Yu
authors.forename: Tse-Ching
authors.initials: TC
authors.lastname: Chen
authors.forename: Chen-Fang
authors.initials: CF
authors.lastname: Lee
authors.forename: Kun-Ming
authors.initials: KM
authors.lastname: Chan
authors.forename: Ting-Jung
authors.initials: TJ
authors.lastname: Wu
authors.forename: Hong-Shiue
authors.initials: HS
authors.lastname: Chou
authors.forename: Wei-Chen
authors.initials: WC
authors.lastname: Lee
authors.forename: Miin-Fu
authors.initials: MF
authors.lastname: Chen
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors