Outcomes of resection of giant hepatocellular carcinoma in a tertiary institution: does size matter?

Autor: Thng Y; Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Department of Surgery, National University Health System Singapore, Singapore., Tan JK; Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Shridhar IG; Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Department of Surgery, National University Health System Singapore, Singapore., Chang SK; Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Department of Surgery, National University Health System Singapore, Singapore., Madhavan K; Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Department of Surgery, National University Health System Singapore, Singapore., Kow AW; Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Department of Surgery, National University Health System Singapore, Singapore.
Jazyk: angličtina
Zdroj: HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2015 Nov; Vol. 17 (11), pp. 988-93. Date of Electronic Publication: 2015 Sep 03.
DOI: 10.1111/hpb.12479
Abstrakt: 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.
(© 2015 International Hepato-Pancreato-Biliary Association.)
Databáze: MEDLINE
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