Outcomes of resection of giant hepatocellular carcinoma in a tertiary institution: does size matter?

BackgroundThe surgical management of giant hepatocellular carcinoma (G-HCC), or HCC of 10cm in diameter, remains controversial. The aim of this study was to compare the outcomes of surgical resection of, respectively, G-HCC and small HCC (S-HCC), or HCC measuring <10cm. MethodsA retrospective review of all patients (n=86) diagnosed with HCC and submitted to resection in a tertiary hospital during the period from January 2007 to June 2012 was conducted. Overall survival (OS), recurrence rates and perioperative mortality at 30days were compared between patients with, respectively, G-HCC and S-HCC. Prognostic factors for OS were analysed. ResultsThe sample included 23 patients with G-HCC (26.7%) and 63 with S-HCC (73.3%) based on histological tumour size. Patient demographics and comorbidities were comparable. Median OS was 39.0months in patients with G-HCC and 65.0months in patients with S-HCC (P=0.213). Although size did not affect OS in this cohort, the presence of satellite lesions [hazard ratio (HR) 3.70, P=0.012] and perioperative blood transfusion (HR 2.85, P=0.015) were negative predictors for OS. ConclusionsSurgical resection of G-HCC provides OS comparable with that after resection of S-HCC.