Ann Surg Treat Res.  2016 Sep;91(3):104-111. 10.4174/astr.2016.91.3.104.

Prognostic factors after hepatic resection for the single hepatocellular carcinoma larger than 5 cm

• Noh JH
• Kim TS
• Ahn KS
• Kim YH
• Kang KJ

• KMID: 2350536
• DOI: http://doi.org/10.4174/astr.2016.91.3.104

Abstract

PURPOSE
This study aimed to determine which factors affect the prognosis of hepatectomy for hepatocellular carcinoma (HCC) larger than 5 cm, including the prognostic difference between tumor sizes from 5-10 cm and larger than 10 cm.
METHODS
The medical records of 114 patients who underwent hepatectomy for single HCC larger than 5 cm were reviewed and analyzed retrospectively.
RESULTS
In the analysis of the entire cohort of 114 patients, the 5-year overall and diseases-free survival rates were 50% and 29%, respectively. In a comparison of survival rates between groups, tumor sizes of 5 to 10 cm and larger than 10 cm, the overall and disease-free survival rates were not significantly different, respectively (54% vs. 41%, P = 0.433 and 33% vs. 23%, P = 0.083). On multivariate analysis, positive hepatitis B, high prothrombin induced by vitamin K absence or antagonist-II levels over 200 mIU/mL, and vascular invasion (micro- and macrovascular invasion) were independent prognostic factors for recurrence after hepatic resection. However, tumor size larger than 10 cm was not significant for recurrence after resection.
CONCLUSION
This study shows that surgical resection of solitary HCC larger than 5 cm showed favorable overall survival. And there is no survival difference with tumors between 5-10 cm and larger than 10 cm.

Keyword

Hepatocellular carcinoma; Hepatectomy; Prognosis

MeSH Terms

Carcinoma, Hepatocellular*
Cohort Studies
Disease-Free Survival
Hepatectomy
Hepatitis B
Humans
Medical Records
Multivariate Analysis
Prognosis
Prothrombin
Recurrence
Retrospective Studies
Survival Rate
Vitamin K
Prothrombin
Vitamin K

Figure

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  Fig. 1 Overall survival curve (A) and recurrence-free survival curve (B) according to tumor size, between 5–10 cm and over 10 cm.

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  Fig. 2 Overall survival curve (A) and recurrence-free survival curve (B) for entire cohort after surgical resection for single hepatocellular carcinoma larger than 5 cm. The 1-, 3-, and 5-year overall survival rates were 79%, 57%, and 50%. The 1-, 3-, and 5-year recurrence-free survival rates were 53%, 36%, and 29%, respectively.

• 

  Fig. 3 Recurrence-free survival curves according to HBV (A), prothrombin induced by vitamin K absence or antagonist-II (B), the presence of portal vein gross invasion (C), and the presence of microvascular invasion (D).

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