title: A retrospective analysis of long term outcomes in patients undergoing hepatic resection for large (>5 cm) hepatocellular carcinoma.
abstract: The treatment of large (>5 cm) hepatocellular carcinoma (HCC) remains controversial. The aim of this study was to report short and long term outcomes and analyze the factors associated with long term survival for patients who underwent hepatic resection for large HCC.
  
  
  
  All patients who underwent hepatic resection for large HCC at the department of Hepato-Pancreato-Biliary Surgery of the First Affiliated Hospital of Anhui Medical University between August 2005 and December 2011 were identified and included for analysis. Demographic and operative data, pathological findings and post-operative outcomes were entered into a computer database. Prognostic factors were analyzed by univariate and multivariate analysis.
  
  
  
  Ninety-nine patients were included for analysis. Two patients died within 30 days of surgery secondary to hepatic failure. The 1-, 3-, 5-year disease-free survival and overall survival rates following hepatic resection were 67%, 49%, 37% and 77%, 56%, 43%, respectively. Poor histological grade was the only independent predictor of a reduced 5-year disease-free survival. Spontaneous tumor rupture and tumor recurrence were independent predictors of a reduced 5-year overall survival.
  
  
  
  For selected patients with large HCC, hepatic resection can be performed safely and effectively with moderate expectation of long term survival. True cure however remains rare.
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
authors.forename: Hong-Chuan
authors.initials: HC
authors.lastname: Zhao
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
authors.forename: Ruo-Lin
authors.initials: RL
authors.lastname: Wu
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
authors.forename: Fu-Bao
authors.initials: FB
authors.lastname: Liu
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
authors.forename: Yi-Jun
authors.initials: YJ
authors.lastname: Zhao
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
authors.forename: Guo-Bin
authors.initials: GB
authors.lastname: Wang
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
authors.forename: Zhi-Gong
authors.initials: ZG
authors.lastname: Zhang
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Huang
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Xie
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China. Electronic address: xp_geng@163.net.
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Geng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002681:China; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012422:Rupture, Spontaneous; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult