Hepatic resection for huge (>15 cm) multinodular HCC with macrovascular invasion.
BACKGROUND
Surgical resection has routinely not been recommended for patients with huge (>15 cm) multinodular lesions and macrovascular invasion (advanced-stage hepatocellular carcinoma [HCC] patients) because of high operative mortality, recurrence rate, and lack of survival benefit.


METHODS
A retrospective study of 1425 patients was carried out, of which 1245 patients met EASL/AASLD criteria for hepatic resection (HR-EA group), 116 were surgically treated advanced-stage HCC patients (HR-AS group), and 64 were advanced-stage HCC patients receiving nonsurgical treatments (N-AS group).


CONCLUSIONS
HR may still be suitable for the HCC patients with huge (>15 cm) multinodular lesions and macrovascular invasion in selected cases. Advanced-stage HCC patients without liver cirrhosis and with a tumor-free resection margin could enjoy longer survival and lower recurrence. Preoperative and/or postoperative TACE provides no survival benefits for advanced-stage HCC patients.
Division of Liver Transplantation, Department of Hepato-Biliary-Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Jiwei
J
Huang
Roberto
R
Hernandez-Alejandro
Kristopher P
KP
Croome
Yong
Y
Zeng
Hong
H
Wu
Zheyu
Z
Chen
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016461:Chemoembolization, Therapeutic; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D016016:Proportional Hazards Models; D012189:Retrospective Studies