Surgery for Large Primary Liver Cancer More Than 10 Cm in Diameter

Overview

Journal J Cancer Res Clin Oncol

Specialty Oncology

Date 2003 Aug 5

PMID 12898232

Citations 17

Authors

Xin-DA Zhou

Zhao-You Tang

Zeng-Chen Ma

Zhi-Quan Wu

Jia Fan

Lun-Xiu Qin

Bo-Heng Zhang

Affiliations

Soon will be listed here.

Abstract

Purpose: Large primary liver cancer (PLC) more than 10 cm in diameter is not infrequently encountered in clinical practice. This study evaluated the clinicopathological features and long-term results after surgery for large PLC.

Methods: Comparison of clinicopathological data between patients with PLC >/=10 cm ( n=1,227) and PLC <10 cm ( n=2,349) during the same period.

Results: In comparison with patients with PLC <10 cm, patients with PLC >/=10 cm were significantly younger ( P<0.01), had a lower incidence of asymptomatic tumors (9.1% vs 39.5%, P<0.001), higher alpha-fetoprotein levels ( >400 ng/ml, 78.3% vs 49.2%, P<0.001), higher gamma-glutamyl transpeptidase levels ( >6U, 87.7% vs 70.5%, P<0.001), a lower incidence of a history of hepatitis (45.0% vs 61.4%, P<0.001) and associated macronodular cirrhosis (cirrhotic nodules >/=0.3 cm, 59.8% vs 66.6%, P<0.001), poor differentiation of tumor cells (Edmondson grade 3-4, 24.3% vs 19.7%, P<0.01), a lower percentage of single nodule tumors (59.9% vs 75.4%, P<0.001) and well-encapsulated tumors (28.5% vs 62.1%, P<0.001), a higher proportion of tumor emboli in the portal vein (20.5% vs 9.0%, P<0.001), a lower resection rate (50.6% vs 86.8%, P<0.001), a lower curative resection rate (54.8% vs 78.3%, P<0.001), a higher operative mortality rate (4.5% vs 2.3%, P<0.001), and less local resection (52.5% vs 80.2%, P<0.001). The 5- and 10-year survival rates after resection were 26.2% and 17.5%, respectively, for patients with PLC >/=10 cm ( n=621), and 54.3% and 39.5%, respectively, for patients with PLC <10 cm ( n=2039) ( P<0.01).

Conclusions: Large PLC had specific clinicopathological features. Surgery is the first choice of treatment. In selected patients, resection is safe and offers the chance of long-term survival. Large PLC does not exclude the possibility of cure.

Citing Articles

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Outcomes of surgical resection of super-giant (≥15 cm) hepatocellular carcinoma: Volume does matter, if not the size.

Wee J, Tee C, Junnarkar S, Low J, Tan Y, Huey C J Clin Transl Res. 2022; 8(3):209-217.

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Effect of Radiofrequency Ablation with Interventional Therapy of Hepatic Artery on the Recurrence of Primary Liver Cancer and the Analysis of Influencing Factors.

Zhang S, Zhao G, Dong H J Oncol. 2021; 2021:3392433.

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Systematic review of the outcomes of surgical resection for intermediate and advanced Barcelona Clinic Liver Cancer stage hepatocellular carcinoma: A critical appraisal of the evidence.

Koh Y, Tan H, Lye W, Kam J, Heng Chiow A, Tan S World J Hepatol. 2018; 10(6):433-447.

PMID: 29988922 PMC: 6033716. DOI: 10.4254/wjh.v10.i6.433.

The hepatectomy efficacy of huge hepatocellular carcinoma and its risk factors: A meta analysis.

Wang L, Liu Z, Liu X, Zeng Y, Liu J Medicine (Baltimore). 2018; 96(52):e9226.

PMID: 29384907 PMC: 6392948. DOI: 10.1097/MD.0000000000009226.

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