Is hepatic resection for large or multinodular hepatocellular carcinoma justified? Results from a multi-institutional database.

Abstract:

BACKGROUND:The role of surgical resection in patients with large or multinodular hepatocellular carcinoma (HCC) remains unclear. This study evaluated the long-term outcome of patients with hepatic resection for large (>5 cm in diameter) or multinodular (more than three nodules) HCC by using a multi-institutional database. METHODS:The perioperative and long-term outcomes of 404 patients with small HCC (<5 cm in diameter; group 1) were compared with those of 380 patients with large or multinodular HCC (group 2). The prognostic factors in the latter group were analyzed. RESULTS:The postoperative complication rate (27% vs. 23%; P = .16) and hospital mortality rate (2.4% vs. 2.7%; P = .82) were similar between groups. The overall survival rates were significantly higher in group 1 than group 2 (1 year, 88% vs. 74%; 3 years, 76% vs. 50%; 5 years, 58% vs. 39%; P < .001). Among patients in group 2, five independent prognostic factors were identified to be associated with a worse overall survival: namely, symptomatic disease, presence of cirrhosis, multinodular tumor, microvascular tumor invasion, and positive histological margin. CONCLUSIONS:Hepatic resection can be safely performed in patients with large or multinodular HCC, with an overall 5-year survival rate of 39%. Symptomatic disease, the presence of cirrhosis, a multinodular tumor, microvascular invasion, and a positive histological margin are independently associated with a less favorable survival outcome.

journal_name

Ann Surg Oncol

authors

Ng KK,Vauthey JN,Pawlik TM,Lauwers GY,Regimbeau JM,Belghiti J,Ikai I,Yamaoka Y,Curley SA,Nagorney DM,Ng IO,Fan ST,Poon RT,International Cooperative Study Group on Hepatocellular Carcinoma.

doi

10.1245/ASO.2005.06.004

keywords:

subject

Has Abstract

pub_date

2005-05-01 00:00:00

pages

364-73

issue

5

eissn

1068-9265

issn

1534-4681

journal_volume

12

pub_type

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