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

Authors
 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 
Citation
 American Journal of Surgery, Vol.198(5) : 693-701, 2009 
Journal Title
 American Journal of Surgery 
ISSN
 0002-9610 
Issue Date
2009
Abstract
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.
Full Text
http://www.sciencedirect.com/science/article/pii/S0002961008008738
DOI
10.1016/j.amjsurg.2008.09.019
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
강창무(Kang, Chang Moo) ORCID logo https://orcid.org/0000-0002-5382-4658
김경식(Kim, Kyung Sik) ORCID logo https://orcid.org/0000-0001-9498-284X
김도영(Kim, Do Young)
김동현(Kim, Dong Hyun)
박영년(Park, Young Nyun) ORCID logo https://orcid.org/0000-0003-0357-7967
박준용(Park, Jun Yong) ORCID logo https://orcid.org/0000-0001-6324-2224
이우정(Lee, Woo Jung) ORCID logo https://orcid.org/0000-0001-9273-261X
전재윤(Chon, Chae Yoon)
최기홍(Choi, Gi Hong) ORCID logo https://orcid.org/0000-0002-1593-3773
최새별(Choi, Sae Byeol)
최진섭(Choi, Jin Sub)
한광협(Han, Kwang-Hyub) ORCID logo https://orcid.org/0000-0003-3960-6539
한대훈(Han, Dai Hoon) ORCID logo https://orcid.org/0000-0003-2787-7876
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/105490
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