title: Outcomes of hepatic resection for large hepatocellular carcinoma: special reference to postoperative recurrence.
abstract: Safety and efficacy of hepatic resection for large hepatocellular carcinomas (HCCs 10 cm or greater in diameter) remain controversial. Surgical results of patients with HCCs 10 cm or greater (n = 24) who underwent hepatic resection over an 11-year period were compared with those of patients with HCCs less than 10 cm (n = 291). There was no significant difference in mortality between the two groups (P > 0.99). Overall 5-year survival rate was 44.6 per cent among patients with HCCs 10 cm or greater and 70.5 per cent among those with HCCs less than 10 cm (P = 0.010); however, there was no significant difference in disease-free survival rate between the two groups (P = 0.16). Incidence of synchronous intra- and extrahepatic recurrence was higher in patients with HCCs 10 cm or greater than in those with HCCs less than 10 cm (P = 0.0012). Macrovascular invasion alone was an independent risk factor for poor prognosis (hazard ratio [HR],: 11.1) and recurrence (HR, 6.02) after hepatic resection for HCCs 10 cm or greater, which was correlated with synchronous intra- and extrahepatic recurrence. Hepatic resection for large HCCs is safe and efficacious. However, incidence of synchronous intra- and extrahepatic recurrence is high, especially in patients with macrovascular invasion.
authors.affiliation: Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Tanaka
authors.forename: Yuji
authors.initials: Y
authors.lastname: Iimuro
authors.forename: Tadamichi
authors.initials: T
authors.lastname: Hirano
authors.forename: Seikan
authors.initials: S
authors.lastname: Hai
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Suzumura
authors.forename: Jiro
authors.initials: J
authors.lastname: Fujimoto
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome