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Hepatic resection for large hepatocellular carcinoma
K Hanazaki1, S Kajikawa, N Shimozawa
1Second Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Japan. hanayan@hsp.md.shinshu-u.ac.jp
Background:
Long-term survival and prognostic factors after hepatic resection for large hepatocellular carcinoma (HCC) remain to be proved.
Methods:
The surgical outcome in 133 consecutive patients with HCC in diameter of > or = 5 cm (large HCC; L group) undergoing hepatic resection was retrospectively clarified and compared with that of 253 patients with HCC in diameter of < 5 cm (small HCC; S group). Postresection prognostic factors were evaluated by univariate and multivariate analysis using Cox's proportional hazards model.
Results:
The disease-free 3- and 5-year survival rates between L group and S group were 26% versus 42% and 20% versus 25%, respectively (P = 0.0032). The overall 3- and 5-year survival rates between L group and S group were 38% versus 67% and 28% versus 47%, respectively (P < 0.0001). Multivariate analysis revealed that large amount of intraoperative blood transfusion was an independently significant factor of poor disease-free and overall survivals.
Conclusions:
Long-term survival in patients with large HCC remains unsatisfactory compared with that in patients with non-large HCC. Restriction of intraoperative blood transfusion may play an important role in the improvement of survival and recurrence in such patients.