Outcomes of resection of giant hepatocellular carcinoma in a tertiary institution: does size matter?. Issue 11 (November 2015) - Thng, Yongxian
Abstract: Background: The surgical management of giant hepatocellular carcinoma (G‐HCC), or HCC of ≥10 cm in diameter, remains controversial. The aim of this study was to compare the outcomes of surgical resection of, respectively, G‐HCC and small HCC (S‐HCC), or HCC measuring <10 cm. Methods: A retrospective review of all patients ( n = 86) diagnosed with HCC and submitted to resection in a tertiary hospital during the period from January 2007 to June 2012 was conducted. Overall survival (OS), recurrence rates and perioperative mortality at 30 days were compared between patients with, respectively, G‐HCC and S‐HCC. Prognostic factors for OS were analysed. Results: The sample included 23 patients with G‐HCC (26.7%) and 63 with S‐HCC (73.3%) based on histological tumour size. Patient demographics and comorbidities were comparable. Median OS was 39.0 months in patients with G‐HCC and 65.0 months in patients with S‐HCC ( P = 0.213). Although size did not affect OS in this cohort, the presence of satellite lesions [hazard ratio (HR) 3.70, P = 0.012] and perioperative blood transfusion (HR 2.85, P = 0.015) were negative predictors for OS. Conclusions: Surgical resection of G‐HCC provides OS comparable with that after resection of S‐HCC.