title: Hepatic resection for multiple hepatocellular carcinoma less than 5 cm: a prospective comparative study.
abstract: OBJECTIVE
  Treatment of multiple hepatocellular carcinoma (HCC) remains a critical issue. In addition, the prognosis and prognostic factors of multiple HCC after hepatic resection are rarely prospectively documented.
  
  
  METHODS
  The clinicopathologic and follow-up data of 81 patients who underwent curative resection of HCC between January 2008 and January 2009 were prospectively collected. Patients were categorized according to the size of the largest tumor: group A (n = 40, two or three HCCs with maximum tumor diameter > 3 cm and < or = 5 cm) and group B (n = 41, two or three HCCs with maximum tumor diameter < or = 3 cm). The two groups were compared for clinicopathologic data and survival results.
  
  
  RESULTS
  The 1-, 2-, 3-, and 4-year survival rates of group A were 75.0%, 58.0%, 50.0%, and 44.0%, respectively, while the survival rates of group B were 93.0%, 80.0%, 66.0%, and 47.0%, respectively. The 1-, 2-, 3-, and 4-year disease-free survival rates of group A were 43.0%, 30.0%, 23.0%, and 15.0%, respectively, comparing to 71.0%, 54.0%, 44.0%, and 36.0% in group B, respectively. The median overall cumulative survival time of group A and group B were 36.0 and 44.5 months, respectively (P = 0.322). The median disease-free survival time of group A was 10.0 months and was significantly shorter than that of group B (30.0 months, P = 0.011).
  
  
  CONCLUSIONS
  Resection may provide comparative survival benefits even for patients with multiple HCCs with maximum tumor diameter > 3 cm and < or = 5 cm.
authors.forename: Wei-Feng
authors.initials: WF
authors.lastname: Shen
authors.forename: Lu
authors.initials: L
authors.lastname: Wu
authors.forename: Hui
authors.initials: H
authors.lastname: Dong
authors.forename: Cheng-Jun
authors.initials: CJ
authors.lastname: Sui
authors.forename: Bing-Hua
authors.initials: BH
authors.lastname: Dai
authors.forename: Rong-Xi
authors.initials: RX
authors.lastname: Shen
authors.forename: Jia-Mei
authors.initials: JM
authors.lastname: Yang
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009378:Neoplasms, Multiple Primary / Q000601:surgery*; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome