Outcomes of Hepatic Resection for Huge Hepatocellular Carcinoma (≥10 cm in Diameter)

Background: The object of the current study was to review the outcomes of hepatic resection for hepatocellular carcinoma (HCC) >= 10 cm. Methods: Between 1995 and 2007, fifty-three patients with HCC >= 10 cm underwent hepatic resection, and clinical data were compared to those of patients with non-surgical treatment (n = 12). Surgical results for HCC >= 10 cm were compared to those of patients with HCC < 10 cm (n = 412). The independent poor prognostic factors of the patients with HCC >= 10 cm were identified. Results: Overall survival was significantly better in patients with hepatic resection for HCC >= 10 cm than in those with non-surgical treatment (P < 0.01). Survival rates of patients with hepatic resection for HCC >= 10 cm were 35% at 5 years. Morbidity and mortality rate were statistically equal. The independent poor prognostic factors of patients with hepatic resection for HCC >= 10 cm were revealed: T4 status, macroscopic tumor thrombus in portal vein (VP+), and the use of intra-operative transfusion. Conclusion: Hepatic resections for HCC >= 10 cm are safe and efficacious. Minimizing intra-operative blood loss and the establishment of an effective systemic treatment for patients with HCC >= 10 cm in T4 appear to be critical. J. Surg. Oncol. 2011;104:292-298. (C) 2011 Wiley-Liss, Inc.