Huge hepatocellular carcinoma greater than 10 cm in diameter worsens prognosis by causing distant recurrence after curative resection.

Abstract

BACKGROUND AND OBJECTIVES:

This study aimed to evaluate the impact of huge (≥10 cm) hepatocellular carcinoma (HCC) to the recurrence pattern and the prognosis after hepatectomy.

METHODS:

574 patients who underwent hepatectomy by 17 surgeons (Open 536 and Laparoscopic 38) for HCC without major vascular invasion from 1990 to 2013 at single institute were retrospectively analyzed.

RESULTS:

Huge tumor, age, HCV, multiple tumors and microscopic portal invasion are independent risk factors for overall survival (OS), and huge tumor, ICGR15 ≥16%, multiple tumors, moderate/poor histology, microscopic portal invasion and a positive pathological margin are risk factors for relapse-free survival (RFS). The 5-year OS and RFS of patients with huge HCC (n = 53) (42.9 and 14.2%) were significantly worse than those of patients with HCC <10 cm (n = 521) (71.3 and 33.1%). Huge tumor is an independent risk factor for initial extra-hepatic recurrence (Hazard ratio 7.86, P < 0.0001). The 5-year OS of patients with initial extra-hepatic recurrence (n = 55) was significantly worse than patients with intra-hepatic recurrence (n = 338) (16.8 vs. 50.5%).

CONCLUSIONS:

Huge HCC (≥10 cm) is an independent risk factor due to a high risk for initial extra-hepatic recurrence. Future systemic adjuvant therapy is needed for these patients. J. Surg. Oncol. 2017;115:324-329. © 2016 Wiley Periodicals, Inc.

• Authors: Kenji Wakayama, Toshiya Kamiyama, Hideki Yokoo, Tatsuya Orimo, Shingo Shimada, Takahiro Einama, Hirofumi Kamachi, Akinobu Taketomi
• Journal: Journal of surgical oncology (J Surg Oncol) Vol. 115 Issue 3 Pg. 324-329 (Mar 2017) ISSN: 1096-9098 [Electronic] United States
• PMID: 28192617 (Publication Type: Journal Article)
• Copyright: © 2016 Wiley Periodicals, Inc.

Topics

• Carcinoma, Hepatocellular (blood supply, pathology, surgery)
• Cohort Studies
• Female
• Hepatectomy
• Humans
• Liver Neoplasms (blood supply, pathology, surgery)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (pathology)
• Neoplasm Staging
• Prognosis
• Retrospective Studies
• Survival Rate
• Treatment Outcome