Ann Surg Treat Res.  2022 Apr;102(4):193-204. 10.4174/astr.2022.102.4.193.

Impact of tumor size on hepatectomy outcomes in hepatocellular carcinoma: a nationwide propensity score matching analysis

• Hong SK
• Lee KW
• Lee S
• Hong Sy
• Suh S
• Han ES
• Choi Y
• Yi NJ
• Suh KS

• KMID: 2527836
• DOI: http://doi.org/10.4174/astr.2022.102.4.193

Abstract

Purpose
The aim of this study was to compare surgical outcomes after liver resection for hepatocellular carcinoma (HCC) according to tumor size using a large, nationwide cancer registry-based cohort and propensity score matching.
Methods
From 2008 to 2015, a total of 12,139 patients were diagnosed with liver cancer and registered in the Korean Primary Liver Cancer Registry. Patients without distant metastasis who underwent hepatectomy as a primary treatment were selected. We performed 1:1 propensity score matching between the small (<5 cm), large (≥5 cm and <10 cm), and huge (≥10 cm) groups.
Results
Overall, 265 patients in the small and large groups were compared, and 64 patients each in the large and huge groups were compared. The overall and progression-free survival rates were significantly lower in the large group than in the small group (P < 0.001 and P < 0.001, respectively). Overall survival tended to be poorer in the huge group than in the large group (P = 0.051). The progression-free survival rate was significantly lower in the huge group than in the large group (P = 0.002).
Conclusion
Although primary liver resection can be considered even in patients with huge HCC, greater caution with careful screening for recurrence is needed.

Keyword

Disease progression; Hepatectomy; Hepatocellular carcinoma; Survival

Figure

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  Fig. 1 Flowchart of the enrolled patients. KPLCR, Korean Primary Liver Cancer Registry; HCC, hepatocellular carcinoma.

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  Fig. 2 Kaplan-Meier analysis of survival comparing small and large groups. (A) Overall survival, (B) progression-free survival.

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  Fig. 3 Kaplan-Meier analysis of survival comparing large and huge groups. (A) Overall survival, (B) progression-free survival.

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