Tumor size is not a criterion for resection during the management of giant hemangioma of the liver.
BACKGROUND
Liver hemangiomas are the most common benign liver tumors. The management of giant (≥5 cm) hemangioma of the liver remains controversial. The aim of this study was to assess the influence of tumor size on postoperative outcomes after hepatectomy in patients with giant hemangioma of the liver.


METHODS
Patients who were subjected to resection because of giant liver hemangioma between December 2006 and July 2012 were grouped by largest tumor size: 5-10 cm (group A) and 10-15 cm (group B). All patients underwent detailed preoperative assessments. Clinicopathologic features were analyzed, and univariate and multivariate analyses were used to determine risk factors that correlated independently with any complication, as well as the intraoperative red blood cell transfusion requirement. Long-term outcomes were assessed with a median follow-up of 56 months.


RESULTS
One hundred and ninety patients, mean age 46 years, were included. The 146 patients with tumors 5-10 cm in size were compared with the remaining 44 patients with tumors 5-10 cm in size. The differences in postoperative morbidity (29.86 vs. 41.30%, P=0.150) and duration of hospitalization (11.06±7.02 vs. 12.17±7.74, P=0.465) between group A and group B did not reach statistical significance. Operation time, blood loss, and transfusion volume of group B were greater than those of group A. No perioperative deaths occurred and no recurrences were registered during follow-up in both groups. The results of univariate and multivariate analysis showed that diameter was not an independent risk factor of postoperative complications and intraoperative red blood cell transfusion.


CONCLUSIONS
Giant hemangiomas should be monitored regularly. Asymptomatic tumors 5-10 cm in diameter can be managed conservatively even though they grow. When necessary, surgical treatment can be well justified because of low morbidity and mortality.
aDepartment of Hepatobiliary Surgery bInstitute of Advanced Surgical Technology and Engineering cDepartment of Neurosurgery and Institute of Urinary Surgery dDepartment of Urinary Surgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Jian
J
Dong
Meng
M
Zhang
Jia-qi
JQ
Chen
Feng
F
Ma
Hao-hua
HH
Wang
Yi
Y
Lv
D000328:Adult; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D005260:Female; D005500:Follow-Up Studies; D006391:Hemangioma / Q000473:pathology* / Q000601:surgery*; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D007902:Length of Stay; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D047368:Tumor Burden