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Updated: Aug 15, 2026
Application of Hemostatic Devices in Laparoscopic Hepatectomy
Published on: April 19, 2022
Outcome of partial hepatectomy for large (> 10 cm) hepatocellular carcinoma
Kui-Hin Liau1, Leyo Ruo, Jinru Shia
1Hepatobiliary Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Background:
Surgical resection for large (> 10 cm) hepatocellular carcinoma (HCC) is believed by many to be ineffective. The objective of the current study was to review the outcome of partial hepatectomy in patients with large HCC.
Methods:
Between 1985 and 2002, 193 consecutive patients who underwent partial hepatectomy for HCC were identified from a prospective database. The 82 patients with tumors > 10 cm were compared with the remaining 111 patients with < or = 10 cm tumors. Clinicopathologic features were analyzed and prognostic factors were evaluated by univariate and multivariate analysis.
Results:
The 5-year overall survival for patients with large HCC was 33% with a median of 32 months. Patients with < or = 10 cm tumors had similar survival. Furthermore, there was no significant difference between the groups in operative mortality (2% in large HCC vs. 6%) or recurrence rate. In patients with large HCC, vascular invasion by tumor and intraoperative blood loss > 2 liters predicted overall survival on multivariate analysis.
Conclusions:
Partial hepatectomy is safe for patients with large HCC. In selected patients with large tumors, resection achieves similar overall survival and recurrence-free survival to that of patients with smaller tumors. Minimizing intraoperative blood loss appears to be critical for favorable long-term outcome in patients with large HCC.
