10cm이상 거대 간세포암의 절제 후 성적

Abstract

Purpose: Recent studies have reported improved perioperative and long-term outcomes for the 이우정1,4initial postoperative results for patients with a huge HCC. The purpose of this study was toinvestigate the surgical outcomes of patients with a huge HCC and we wanted to identify anysubgroup that would likely benefit from hepatic resection.Methods: From January 1996 to August 2006, 55 patients were diagnosed with a huge HCC (≥10cm in diameter). All the tumors were classified as either the expanding nodular type or thenon- expanding nodular type.Results: The mean age of the patients was 50.6 years and 39 patients were male. The mostcommon cause of liver disease was hepatitis B virus. The mean size of tumor was 11.9 cm.Microscopic liver cirrhosis was present in 17 patients. Twenty-three patients had tumors of theexpanding nodular type. Curative resection was performed in 50 patients. The 5-year diseasefreeand overall survival rates after resection were 35.8% and 41.0%, respectively. Univariateanalysis revealed that surgical margins of ≤ 1.0, a non-curative resection, the non-expandingnodular type and microscopic vascular invasion were adverse prognostic factors for survival.Multivariate analysis indicated that the gross tumor classification (expanding nodular vs. nonexpandingnodular) was the only independent prognostic factor.Conclusions: Huge HCC is not a homogenous group and the gross tumor pattern mayrepresent the biologic behavior of huge HCC. Because the outcome of surgical treatment is farbetter than that of non-surgical treatment, resection should be actively considered for patientswith a huge HCC. An expanding nodular type tumor is the best candidate for surgical resection.