Related Experiment Video
Updated: Mar 3, 2026

Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
Published on: March 10, 2023
Liver resection for hepatocellular carcinoma ≥5 cm
Giuseppe Maria Ettorre1, Giovanni Battista Levi Sandri1, Marco Colasanti1
1Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Lazio, Italy.
Background:
Management of hepatocellular carcinoma (HCC) larger than 5 cm is still debated. The aim of our study was to compare morbidity and mortality after the surgical resection of HCC according to the nodule size.
Methods:
Since 2001, 429 liver resections for HCC were performed in our institution. We divided the cohort into two groups, 88 patients in group 1 patients with HCC diameter from 5 to 10 cm and 39 patients in group 2 with HCC diameter ≥10 cm.
Results:
In 30.7% of cases in the first group and in 35.9% of cases in the second group the HCC grew into a healthy liver. A major liver resection was performed in 36.3% of cases in group 1 vs. 66.6% in group 2 (P=0.001). In two cases for the first group and in ten cases in the second group a laparoscopic approach was performed. Median operative time was higher in group 2 (P=0.001). The median post-operative hospital stay was similar in the two groups (P=0.897). The post-operative morbidity was not different between the two groups (P=0.595).
Conclusions:
The tumour size does not contraindicate a surgical resection of HCC even in patient with HCC ≥10 cm.

