BACKGROUND: A curative hepatectomy is the mainstay of effective treatment for small hepatocellular carcinoma (HCC), but the treatment of large HCC remains challenging. MATERIALS AND METHODS: The possible prognostic factors were retrospectively analyzed in 85 patients with large HCC (> or = 10.0 cm) who all underwent a hepatectomy for HCC between 1988 and 2004. A survival analysis was made by classifying the tumors into four spreading patterns according to the number of tumors and the presence of macroscopic tumor thrombus. RESULTS: A positive hepatitis B antigen, the earlier period of hepatectomy, a non-curative hepatectomy, multiple tumors, and portal vein invasion were identified as independent predictors of a poor prognosis. The median survival term and 5-year survival rate of patients with a solitary large HCC without a macroscopic tumor thrombus was 9.8 years and 69.8%, respectively. The tumor spreading patterns according to the number of tumors and the presence of a macroscopic tumor thrombus were statistically associated with a non-curative hepatectomy (p < 0.001). There was a statistical difference among 33 patients with large HCC undergoing a non-curative hepatectomy based on the presence of a macroscopic portal vein invasion (p = 0.0089). CONCLUSION: A hepatectomy could yield an excellent long-term survival in patients with a solitary large HCC without a macroscopic tumor thrombus. Even if a curative hepatectomy could not be achieved, a hepatectomy might provide better survival in large HCC patients without a macroscopic tumor thrombus compared in those with macroscopic tumor thrombus.
BACKGROUND: A curative hepatectomy is the mainstay of effective treatment for small hepatocellular carcinoma (HCC), but the treatment of large HCC remains challenging. MATERIALS AND METHODS: The possible prognostic factors were retrospectively analyzed in 85 patients with large HCC (> or = 10.0 cm) who all underwent a hepatectomy for HCC between 1988 and 2004. A survival analysis was made by classifying the tumors into four spreading patterns according to the number of tumors and the presence of macroscopic tumor thrombus. RESULTS: A positive hepatitis B antigen, the earlier period of hepatectomy, a non-curative hepatectomy, multiple tumors, and portal vein invasion were identified as independent predictors of a poor prognosis. The median survival term and 5-year survival rate of patients with a solitary large HCC without a macroscopic tumor thrombus was 9.8 years and 69.8%, respectively. The tumor spreading patterns according to the number of tumors and the presence of a macroscopic tumor thrombus were statistically associated with a non-curative hepatectomy (p < 0.001). There was a statistical difference among 33 patients with large HCC undergoing a non-curative hepatectomy based on the presence of a macroscopic portal vein invasion (p = 0.0089). CONCLUSION: A hepatectomy could yield an excellent long-term survival in patients with a solitary large HCC without a macroscopic tumor thrombus. Even if a curative hepatectomy could not be achieved, a hepatectomy might provide better survival in large HCC patients without a macroscopic tumor thrombus compared in those with macroscopic tumor thrombus.
Authors: Y Shiratori; S Shiina; M Imamura; N Kato; F Kanai; T Okudaira; T Teratani; G Tohgo; N Toda; M Ohashi Journal: Hepatology Date: 1995-10 Impact factor: 17.425
Authors: K Shirabe; M Shimada; K Kajiyama; T Gion; Y Ikeda; H Hasegawa; K Taguchi; K Takenaka; K Sugimachi Journal: Cancer Date: 1998-12-01 Impact factor: 6.860
Authors: O Matsui; M Kadoya; J Yoshikawa; T Gabata; K Arai; H Demachi; S Miyayama; T Takashima; M Unoura; K Kogayashi Journal: Radiology Date: 1993-07 Impact factor: 11.105
Authors: Jian-Hong Zhong; A Chapin Rodríguez; Yang Ke; Yan-Yan Wang; Lin Wang; Le-Qun Li Journal: Medicine (Baltimore) Date: 2015-01 Impact factor: 1.889