Outcome after curative resection for a huge (≥10 cm) hepatocellular carcinoma and prognostic significance of gross tumor classification

Gi Hong Choi, Dai Hoon Han, Dong Hyun Kim, Sae Byeol Choi, ChangMoo Kang, Kyung Sik Kim, Jin Sub Choi, Young Nyun Park, Junyong Park, doyoung kim, KwangHyub Han, Chae Yoon Chon, Woo Jung Lee

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Abstract

Background and objectives: The purpose of this study was to investigate the surgical outcomes in patients with huge (≥10 cm) hepatocellular carcinoma (HCC). Methods: Clinicopathological features and surgical outcomes of 50 patients with huge HCC who underwent curative resection (group A) were compared with 447 patients with smaller tumors (group B). In group A, we investigated prognostic factors. Results: Group A patients had a higher incidence of α-fetoprotein at more than 1,000 IU/mL, microscopic vascular invasion, and advanced stage tumors. The disease-free survival of group A was significantly worse than group B. The rates of initial extrahepatic recurrence and early recurrence were higher in group A. The 5 year-overall survival of group A was 40.2%, significantly lower than that of group B (65.9% at 5 years). In group A, multivariate analysis revealed that the presence of single nodular type tumors was the only good prognostic factor for survival. Conclusions: Huge HCCs exhibit a more aggressive clinical behavior and worse survival. However, because the outcome of surgical treatment is far better than that of nonsurgical treatment, resection should be actively considered for patients with huge HCC. A single nodular type tumor is the best candidate for surgical resection.

Original languageEnglish
Pages (from-to)693-701
Number of pages9
JournalAmerican Journal of Surgery
Volume198
Issue number5
DOIs
Publication statusPublished - 2009 Nov 1

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Hepatocellular Carcinoma
Neoplasms
Survival
Fetal Proteins
Recurrence
Disease-Free Survival
Blood Vessels
Multivariate Analysis
Incidence
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Choi, Gi Hong ; Han, Dai Hoon ; Kim, Dong Hyun ; Choi, Sae Byeol ; Kang, ChangMoo ; Kim, Kyung Sik ; Choi, Jin Sub ; Park, Young Nyun ; Park, Junyong ; kim, doyoung ; Han, KwangHyub ; Chon, Chae Yoon ; Lee, Woo Jung. / Outcome after curative resection for a huge (≥10 cm) hepatocellular carcinoma and prognostic significance of gross tumor classification. In: American Journal of Surgery. 2009 ; Vol. 198, No. 5. pp. 693-701.
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abstract = "Background and objectives: The purpose of this study was to investigate the surgical outcomes in patients with huge (≥10 cm) hepatocellular carcinoma (HCC). Methods: Clinicopathological features and surgical outcomes of 50 patients with huge HCC who underwent curative resection (group A) were compared with 447 patients with smaller tumors (group B). In group A, we investigated prognostic factors. Results: Group A patients had a higher incidence of α-fetoprotein at more than 1,000 IU/mL, microscopic vascular invasion, and advanced stage tumors. The disease-free survival of group A was significantly worse than group B. The rates of initial extrahepatic recurrence and early recurrence were higher in group A. The 5 year-overall survival of group A was 40.2{\%}, significantly lower than that of group B (65.9{\%} at 5 years). In group A, multivariate analysis revealed that the presence of single nodular type tumors was the only good prognostic factor for survival. Conclusions: Huge HCCs exhibit a more aggressive clinical behavior and worse survival. However, because the outcome of surgical treatment is far better than that of nonsurgical treatment, resection should be actively considered for patients with huge HCC. A single nodular type tumor is the best candidate for surgical resection.",
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Outcome after curative resection for a huge (≥10 cm) hepatocellular carcinoma and prognostic significance of gross tumor classification. / Choi, Gi Hong; Han, Dai Hoon; Kim, Dong Hyun; Choi, Sae Byeol; Kang, ChangMoo; Kim, Kyung Sik; Choi, Jin Sub; Park, Young Nyun; Park, Junyong; kim, doyoung; Han, KwangHyub; Chon, Chae Yoon; Lee, Woo Jung.

In: American Journal of Surgery, Vol. 198, No. 5, 01.11.2009, p. 693-701.

Research output: Contribution to journalArticle

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AU - Han, Dai Hoon

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AU - Choi, Sae Byeol

AU - Kang, ChangMoo

AU - Kim, Kyung Sik

AU - Choi, Jin Sub

AU - Park, Young Nyun

AU - Park, Junyong

AU - kim, doyoung

AU - Han, KwangHyub

AU - Chon, Chae Yoon

AU - Lee, Woo Jung

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N2 - Background and objectives: The purpose of this study was to investigate the surgical outcomes in patients with huge (≥10 cm) hepatocellular carcinoma (HCC). Methods: Clinicopathological features and surgical outcomes of 50 patients with huge HCC who underwent curative resection (group A) were compared with 447 patients with smaller tumors (group B). In group A, we investigated prognostic factors. Results: Group A patients had a higher incidence of α-fetoprotein at more than 1,000 IU/mL, microscopic vascular invasion, and advanced stage tumors. The disease-free survival of group A was significantly worse than group B. The rates of initial extrahepatic recurrence and early recurrence were higher in group A. The 5 year-overall survival of group A was 40.2%, significantly lower than that of group B (65.9% at 5 years). In group A, multivariate analysis revealed that the presence of single nodular type tumors was the only good prognostic factor for survival. Conclusions: Huge HCCs exhibit a more aggressive clinical behavior and worse survival. However, because the outcome of surgical treatment is far better than that of nonsurgical treatment, resection should be actively considered for patients with huge HCC. A single nodular type tumor is the best candidate for surgical resection.

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