Prognosis of patients with huge hepatocellular carcinoma after R0 resection / 中华肝胆外科杂志

ABSTRACT

Objective To study the prognosis of patients with huge hepatocellular carcinoma (HCC) after R0 resection.Methods 517 patients with primary HCC who underwent R0 resection from January 1997 to December 2008 at the Affiliated Hospital of Medical College Qingdao University were analyzed retrospectively.Results The 5-and 10-years overall survivals (OS) in patients with huge HCC (≥10 cm; n=69) and in patients with HCC ＜10 cm (n=448) were 24％,18％ and 49％,30％,respectively.The median OS was 23.0 and 58.0 month (P＜0.001,log rank test) ; and the median disease-free survivals (DFS) were 15.3 and 34.8 month (P＜0.001),respectively.The recurrence rate within the first year and the extrahepatic recurrence after resection in patients with huge HCC was significantly higher than in patients with HCC ＜10 cm (44.9％ vs.24.3％,P=0.022;32.7％ vs.16.0％,P=0.004).Independent poor prognostic factors of OS and DFS for patients with huge HCC after R0 resection were portal hypertension and vascular invasion.Preoperative transcatheter arterial chemoembolization (TACE) was an independent prognostic factor for better DFS.Conclusions Surgical resection for huge HCC is safe and feasible.For huge HCC after resection,portal hypertension and vascular invasion were poor prognostic factors.Preoperative TACE improved DFS after resection.