Efficacy of hepatic resection for huge (≥ 10 cm) hepatocellular carcinoma: good prognosis associated with the uninodular subtype

Abstract

Background: The value of hepatic resection (HR) for huge hepatocellular carcinomas (HCC) (≥ 10 cm in diameter) remains controversial. The aim of this study is to evaluate the efficacy of hepatic resection (HR) for patients with huge HCC.

Methods: A total of 739 patients with huge HCC (≥ 10 cm in diameter) (huge HCC group, n = 244) or small HCC (< 10 cm in diameter) (small HCC group, n = 495) who received initial HR were retrospectively analyzed. Overall survival (OS) and disease-free survival (DFS) were obtained using the Kaplan-Meier method and compared by Log-Rank test. Prognostic factors of huge HCC were identified based on Cox regression analyses.

Results: The hospital mortality of these two groups were similar (P = 0.252). The 5-year OS of huge HCC group and small HCC group were 30.3% and 51.9%, respectively (P < 0.001). Uninodular huge HCC had a significant higher 5-year OS (50.6%) than mutinodular huge HCC (26.9%) (P = 0.016). Multivariate analysis revealed that uninodular huge HCC and absence of PVTT independently predicted better OS for huge HCC patients.

Conclusion: HR is a safe and effective approach for the treatment of huge HCC, especially for the uninodular subtype.

Keywords: Hepatic resection; disease-free survival; hepatocellular carcinoma; huge; mortality; overall survival; uninodular.

Figure 1

Study flowchart.

Figure 2

Overall survival and disease-free survival curves of patients with huge HCC and small HCC.

Figure 3

Overall survival and disease-free curves of patients with uninodular huge HCC and multinodular huge HCC.

Figure 4

Overall survival and disease-free curves of patients with uninodular huge HCC and small HCC.