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Long-term Outcome after Liver Resection for Hepatocellular Carcinoma Larger than 10cm

Allemann, Pierre ; Demartines, Nicolas ; Bouzourene, Hanifah ; Tempia, Adrien ; Halkic, Nermin

In: World Journal of Surgery, 2013, vol. 37, no. 2, p. 452-458

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    Titre
    • Long-term Outcome after Liver Resection for Hepatocellular Carcinoma Larger than 10cm
    Auteur
    • Allemann, Pierre. Department of Visceral Surgery and Transplantation, University Hospital CHUV, Bugnon 46, 1012, Lausanne, Switzerland
    • Demartines, Nicolas. Department of Visceral Surgery and Transplantation, University Hospital CHUV, Bugnon 46, 1012, Lausanne, Switzerland
    • Bouzourene, Hanifah. Department of Pathology, University Hospital CHUV, Bugnon 46, 1012, Lausanne, Switzerland
    • Tempia, Adrien. Department of Visceral Surgery and Transplantation, University Hospital CHUV, Bugnon 46, 1012, Lausanne, Switzerland
    • Halkic, Nermin. Department of Visceral Surgery and Transplantation, University Hospital CHUV, Bugnon 46, 1012, Lausanne, Switzerland
    Type de document
    • Postprint
    Classification
    • Santé
    Identifiant OAI-PMH
    • oai:doc.rero.ch:321477
    Summary
    Background: The purpose of the present study was to analyze long-term survival and disease-free survival after liver resection for giant hepatocellular carcinoma (HCC)≥10cm compared to HCC<10cm in diameter. The surgical approach in the treatment of giant HCC may achieve long-term survival and disease-free survival comparable to treatment of smaller lesions. Methods: This retrospective analysis was a monocentric study conducted in a tertiary university center. It included 101 patients from 114 consecutive liver resections for HCC, separated into two groups: those with tumors less than 10cm in diameter (small HCC; n=79) and those with tumors larger than 10cm (giant HCC; n=22). The main outcome measures were overall five-year survival, five-year disease-free survival, recurrence rate, perioperative mortality at 30days, surgical complication rate, and re-intervention rate. Results: The two groups were homogeneously distributed, apart from cirrhosis, which was found more frequently in the group with small HCC (77 vs. 41%; p=0.0013). Both median survival (24 vs. 27months; p=0.0085) and overall 5-year survival (21 vs. 45; p=0.04) were significantly poorer in the small HCC group compared to the giant HCC group. There were no differences en terms of recurrence rate, pattern, and timing. Conclusions: Liver resection for HCC larger than 10cm is a valuable option in selected patients, one that provides overall survival and disease-free survival comparable to smaller lesions. Functional reserves of the liver, more than the size of the lesion, may be important in patient selection for surgical resection