Outcome of partial hepatectomy for large (> 10 cm) hepatocellular carcinoma Journal Article
| Authors: | Liau, K. H.; Ruo, L.; Shia, J.; Padela, A.; Gonen, M.; Jarnagin, W. R.; Fong, Y.; D'Angelica, M. I.; Blumgart, L. H.; DeMatteo, R. P. |
| Article Title: | Outcome of partial hepatectomy for large (> 10 cm) hepatocellular carcinoma |
| Abstract: | BACKGROUND. Surgical resection for large (> 10 cm) hepatocellular carcinoma (HCC) is believed by many to be ineffective. The objective of the current study was to review the outcome of partial hepatectomy in patients with large HCC. METHODS. Between 1985 and 2002, 193 consecutive patients who underwent partial hepatectomy for HCC were identified from a prospective database. The 82 patients with tumors > 10 cm were compared with the remaining 111 patients with ≤ 10 cm tumors. Clinicopathologic features were analyzed and prognostic factors were evaluated by univariate and multivariate analysis. RESULTS. The 5-year overall survival for patients with large HCC was 33% with a median of 32 months. Patients with ≤ 10 cm tumors had similar survival. Furthermore, there was no significant difference between the groups in operative mortality (2% in large HCC vs. 6%) or recurrence rate. In patients with large HCC, vascular invasion by tumor and intraoperative blood loss > 2 liters predicted overall survival on multivariate analysis. CONCLUSIONS. Partial hepatectomy is safe for patients with large HCC. In selected patients with large tumors, resection achieves similar overall survival and recurrence-free survival to that of patients with smaller tumors. Minimizing intraoperative blood loss appears to be critical for favorable long-term outcome in patients with large HCC. © 2005 American Cancer Society. |
| Keywords: | survival; adult; cancer survival; treatment outcome; aged; disease-free survival; middle aged; survival analysis; cancer surgery; major clinical study; histopathology; hepatocellular carcinoma; liver cell carcinoma; patient selection; carcinoma, hepatocellular; liver neoplasms; recurrence risk; neoplasm recurrence, local; bleeding; statistical significance; evaluation; tumor burden; long term care; outcome; hepatectomy; multivariate analysis; safety; partial hepatectomy; large hcc |
| Journal Title: | Cancer |
| Volume: | 104 |
| Issue: | 9 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2005-11-01 |
| Start Page: | 1948 |
| End Page: | 1955 |
| Language: | English |
| DOI: | 10.1002/cncr.21415 |
| PUBMED: | 16196045 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 41" - "Export Date: 24 October 2012" - "CODEN: CANCA" - "Source: Scopus" |
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