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Updated: May 19, 2026
Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
Published on: March 10, 2023
Impact of hepatectomy for huge solitary hepatocellular carcinoma
Shun-Ichi Ariizumi1, Yoshihito Kotera, Yutaka Takahashi
1Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan. ariizumi@ige.twmu.ac.jp
Background:
To evaluate the surgical outcome of patients with huge solitary hepatocellular carcinoma (HCC, ≥10 cm in diameter) without major vascular invasion.
Methods:
We retrospectively studied 177 patients with huge HCC (≥10 cm in diameter) who underwent hepatectomy from 1990 to 2008. Surgical outcomes and clinicopathological characteristics were compared among 54 patients with solitary HCC without a major portal vein tumor thrombus (MPVT), 53 patients with multiple HCCs without MPVT, and 70 patients who have HCC with MPVT.
Results:
The mean tumor size and indocyanine green retention rate at 15 min showed no significant difference among patients groups. The overall 5-year survival rate was significantly higher in patients with solitary HCC (79%) than in patients with multiple HCCs (31%, P < 0.0001) and MPVT (17%, P < 0.0001). In patients who underwent curative surgery, the 5-year disease-free survival rate was significantly higher in patients with solitary HCC (48%) than in patients with multiple HCCs (12%, P = 0.0008) and MPVT (12%, P = 0.0003). Multivariate analysis showed solitary HCC to be a significant independent prognostic factor for overall survival and disease-free survival.
Conclusions:
Patients with solitary HCC without MPVT show a favorable surgical outcome even for tumor size ≥10 cm in diameter.
