Hepatic resection for large hepatocellular carcinoma

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Hepatocellular Carcinoma Research

Background:

• Long-term survival and prognostic factors for large hepatocellular carcinoma (HCC) after hepatic resection require further investigation.
• Hepatocellular carcinoma (HCC) is a significant global health concern, with large tumors posing unique surgical challenges.

Purpose of the Study:

• To evaluate the surgical outcomes and identify prognostic factors in patients undergoing hepatic resection for large HCC (>= 5 cm).
• To compare the survival rates of patients with large HCC versus small HCC after surgical resection.

Main Methods:

• Retrospective analysis of 133 patients with large HCC (L group) and 253 patients with small HCC (S group) who underwent hepatic resection.
• Univariate and multivariate analyses using Cox's proportional hazards model were employed to identify prognostic factors.

Main Results:

• Disease-free survival rates at 3 and 5 years were significantly lower in the large HCC group (26% vs 42% and 20% vs 25%, respectively).
• Overall survival rates at 3 and 5 years were also significantly lower in the large HCC group (38% vs 67% and 28% vs 47%, respectively).
• Multivariate analysis identified a large volume of intraoperative blood transfusion as an independent predictor of poor disease-free and overall survival.

Conclusions:

• Long-term survival for patients with large HCC following hepatic resection is unsatisfactory compared to those with smaller tumors.
• Reducing intraoperative blood transfusions may be crucial for improving survival and reducing recurrence rates in patients with large HCC.