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.