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Outcome after curative resection for a huge (≥10 cm) hepatocellular carcinoma and prognostic significance of gross tumor classification

 Gi Hong Choi  ;  Dai Hoon Han  ;  Dong Hyun Kim  ;  Sae Byeol Choi  ;  Chang Moo Kang  ;  Kyung Sik Kim  ;  Jin Sub Choi  ;  Young Nyun Park  ;  Jun Yong Park  ;  Do Young Kim  ;  Kwang-Hyub Han  ;  Chae Yoon Chon  ;  Woo Jung Lee 
 AMERICAN JOURNAL OF SURGERY, Vol.198(5) : 693-701, 2009 
Journal Title
Issue Date
Carcinoma, Hepatocellular/mortality* ; Carcinoma, Hepatocellular/pathology* ; Carcinoma, Hepatocellular/surgery ; Disease-Free Survival ; Humans ; Liver Neoplasms/mortality* ; Liver Neoplasms/pathology* ; Liver Neoplasms/surgery ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local/pathology ; Neoplasm Staging ; Prognosis ; Survival Analysis ; Treatment Outcome
Hepatocellular carcinoma ; Huge ; Surgical resection ; Prognosis ; Gross tumor type
BACKGROUND AND OBJECTIVES: The purpose of this study was to investigate the surgical outcomes in patients with huge (>or=10 cm) hepatocellular carcinoma (HCC).

METHODS: Clinicopathological features and surgical outcomes of 50 patients with huge HCC who underwent curative resection (group A) were compared with 447 patients with smaller tumors (group B). In group A, we investigated prognostic factors.

RESULTS: Group A patients had a higher incidence of alpha-fetoprotein at more than 1,000 IU/mL, microscopic vascular invasion, and advanced stage tumors. The disease-free survival of group A was significantly worse than group B. The rates of initial extrahepatic recurrence and early recurrence were higher in group A. The 5 year-overall survival of group A was 40.2%, significantly lower than that of group B (65.9% at 5 years). In group A, multivariate analysis revealed that the presence of single nodular type tumors was the only good prognostic factor for survival.

CONCLUSIONS: Huge HCCs exhibit a more aggressive clinical behavior and worse survival. However, because the outcome of surgical treatment is far better than that of nonsurgical treatment, resection should be actively considered for patients with huge HCC. A single nodular type tumor is the best candidate for surgical resection.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Kim, Do Young(김도영)
Kim, Dong Hyun(김동현)
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Chon, Chae Yoon(전재윤)
Choi, Gi Hong(최기홍) ORCID logo https://orcid.org/0000-0002-1593-3773
Choi, Sae Byeol(최새별)
Choi, Jin Sub(최진섭)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
Han, Dai Hoon(한대훈) ORCID logo https://orcid.org/0000-0003-2787-7876
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