Resection of large hepatocellular carcinoma (≥10 cm): a unique western perspective.


Journal Article

BACKGROUND AND OBJECTIVES: Few Western centers have surgically treated a high volume of large hepatocellular carcinoma 10 cm or more in diameter. The study aim was to analyze a large Western cohort of these patients, and to present our outcomes in the context of the more extensive Eastern experience. METHODS: We retrospectively reviewed all patients at our center receiving partial hepatectomy from January 1992 to August 2010, and analyzed a cohort with hepatocellular carcinoma ≥10 cm in diameter. RESULTS: One hundred thirty patients comprised the cohort. One hundred three (79.2%) of the patients received major anatomic resections, and 23 (17.7%) patients underwent tumor thrombectomy as an adjunct procedure. Perioperative mortality was observed in 9 (6.9%) of cases, but from January 2002 onward, only 2 (2.3%) of the 86 resections performed resulted in a mortality. The survival rate at 1, 3, and 5 years was 56.9%, 30.3%, and 18.8%, respectively; the median survival was 17.0 months. The subgroup of 39 patients without gross vascular invasion and satellite nodules achieved a median survival of 40.3 months. CONCLUSIONS: Resection of large hepatocellular carcinoma can be done with safety at a large Western center, and a subgroup of patients will achieve long-term survival.

Full Text

Duke Authors

Cited Authors

  • Shrager, B; Jibara, GA; Tabrizian, P; Schwartz, ME; Labow, DM; Hiotis, S

Published Date

  • February 2013

Published In

Volume / Issue

  • 107 / 2

Start / End Page

  • 111 - 117

PubMed ID

  • 22903563

Pubmed Central ID

  • 22903563

Electronic International Standard Serial Number (EISSN)

  • 1096-9098

International Standard Serial Number (ISSN)

  • 0022-4790

Digital Object Identifier (DOI)

  • 10.1002/jso.23246


  • eng