title: Optimizing stage of single large hepatocellular carcinoma: A study with subgroup analysis by tumor diameter.
abstract: This study aims to refine the designation for single hepatocellular carcinoma (HCC) >5 cm by comparing the postresection prognosis of these patients with those who have a single-tumor ≤5 cm and those with stage B.Patients with a single-tumor were classified into subgroups based on diameter. Of the 1132 patients analyzed, 426 had a single-tumor >2 and ≤5 cm; 229, a single-tumor >5 and ≤8 cm; 52, a single-tumor >8 and < 10 cm; 150, a single-tumor ≥10 cm; and 275, stage B.Hospital mortality and complications increased with tumor size among the single-tumor subgroups and median survival decreased with increasing of tumor size. Overall survival (OS) among patients with a single-tumor >5 cm was significantly lower than among patients with a single-tumor >2 and ≤5 cm (P ≤ .001), but significantly higher than among patients with clearly stage B (P ≤ .001). Patients with a single-tumor >5 and ≤8 cm showed lower OS than patients with a single-tumor >2 and ≤5 cm (P < .001). Patients with a single-tumor >8 and <10 cm or a single-tumor ≥10 cm showed lower OS than patients with a single-tumor >5 and ≤8 cm (P = .033 and .006), and similar OS to patients with stage B (P = .323).Patients with a single-tumor >5 and ≤8 cm may be assigned to a new stage between early and intermediate. Patients with a single-tumor >8 cm may be assigned to intermediate stage.
authors.affiliation: Department of Hepatobiliary Surgery Anesthesia Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China Department of Medical and Surgical Sciences, S.Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, Bologna, Italy Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 201800, China.
authors.forename: Jian-Hong
authors.initials: JH
authors.lastname: Zhong
authors.forename: Ling-Hui
authors.initials: LH
authors.lastname: Pan
authors.forename: Yan-Yan
authors.initials: YY
authors.lastname: Wang
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cucchetti
authors.forename: Tian
authors.initials: T
authors.lastname: Yang
authors.forename: Xue-Mei
authors.initials: XM
authors.lastname: You
authors.forename: Liang
authors.initials: L
authors.lastname: Ma
authors.forename: Wen-Feng
authors.initials: WF
authors.lastname: Gong
authors.forename: Bang-De
authors.initials: BD
authors.lastname: Xiang
authors.forename: Ning-Fu
authors.initials: NF
authors.lastname: Peng
authors.forename: Fei-Xiang
authors.initials: FX
authors.lastname: Wu
authors.forename: Le-Qun
authors.initials: LQ
authors.lastname: Li
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D047368:Tumor Burden