title: Clinical characteristics and survival of European patients with resectable large hepatocellular carcinomas.
abstract: OBJECTIVE
  Large hepatocellular carcinoma (HCC) presents on cirrhosis or in the absence of cirrhosis. Prognostic factors include both tumor and liver factors. Evaluate clinical and tumor characteristics of a group of large resected HCC in European patients.
  
  
  METHODS
  Data for patients with HCC >7 cm who underwent liver resection between 1992 and 2011 were analyzed. Patients were dichotomized into those with tumor diameters of 7-10 cm or >10 cm and their characteristics and outcomes were compared.
  
  
  RESULTS
  A total of 65 hepatectomies for HCC ≥7 cm were performed. Severe fibrosis or cirrhosis was present in 41.5 % of patients. Thirty-seven (56.9 %) patients had HCC ≥10 cm. Mortality and morbidity rates were 1.5 % and 37.5 %, respectively. Preoperative blood platelet levels and serum alkaline phosphatase (ALKP) levels showed significant differences between the groups. The 3-year survival was 43.5 % and 17.4 % for patients with tumors 7-10 and ≥10 cm, respectively.
  
  
  CONCLUSIONS
  Patients with large size HCC and preserved liver function can be resected with low operative risk. ALKP levels and platelet counts were higher in the larger tumors. Given these patterns of clinical and biochemical characteristics, this group of tumors may be a selected subset of large HCCs and might potentially benefit from surgical resection.
authors.affiliation: Hepatobiliary Surgery Unit, Department of Surgery, School of Medicine, Catholic University of the Sacred Heart, L. go A. Gemelli, 8 00168, Rome, Italy. fgiuliante@rm.unicatt.it
authors.forename: Felice
authors.initials: F
authors.lastname: Giuliante
authors.forename: Agostino Maria
authors.initials: AM
authors.lastname: De Rose
authors.forename: Vito
authors.initials: V
authors.lastname: Guerra
authors.forename: Francesco
authors.initials: F
authors.lastname: Ardito
authors.forename: Gennaro
authors.initials: G
authors.lastname: Nuzzo
authors.forename: Brian I
authors.initials: BI
authors.lastname: Carr
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D015331:Cohort Studies; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000401:mortality*; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate
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