Hepatectomy for huge hepatocellular carcinoma in 634 cases

Table 1 Demographic data of 634 patients with huge hepatocelular carcinoma who underwent liver resection

Sex (male:female)	563:71
Age (yr)1	39 ± 9.5
Total bilirubin (μmol/L)1	12.5 ± 2.8
Alanine aminotransferase (U/L)	36 ± 8.5
Albumin (mmol/L)1	3.8 ± 0.15
Prothrombin times (seconds prolonged)1	1.48 ± 0.8
Maximum size of tumor (cm)1	14.1 ± 2.6
Pugh-Child’s grading, n (%)
A	559 (88.2%)
B	75 (11.8%)
C	0
Alpha fetoprotein ≥ 400 ng/mL	310 (58.9%)2
HBsAg positive	469 (74.0%)
Satellite nodules	139 (26.5%)
Tumor thrombi in portal vein	139 (21.9%)
Associated cirrhosis	547 (86.3%)

¹ mean ± SD.

² number of patient studied = 498.

Table 2 Type of operation (n = 634)

Type of liver resection	n	%
Resection of right three lobes	30	4.8
Resection of right half	44	6.9
Resection of left three lobes	39	6.2
Resection of left half	63	9.9
Segmentectomy 4, 5, 6	33	5.2
Segmentectomy 4, 5, 8	27	4.2
Segmentectomy 5, 6, 7	87	13.7
Segmentectomy 2, 3	128	20.2
Non-anatomical resections	183	28.9
Total	634	100
Combined organ resection
Partial diaphragamectomy	12	1.9
Right adrenal gland resection	9	1.4
Distal gastrectomy	5	0.8
Transverse colectomy	11	1.7
Splenectomy	31	4.9
Splenectomy + devascularization	41	6.5
Portal vein thrombectomy	139	21.9
Total	248	39.1

Table 3 Univariate analysis on prognostic factors associated with long-term survival in patients with huge hepatocellular carcinoma undergoing liver resection

Variable		Patients(n)	Survival rates (%)
			1 yr	2 yr	3 yr	5 yr
Patients
Sex	Male	332	65.1	43.7	33.7	15.1	P < 0.05
	Female	24	83.3	70.8	45.8	37.5
Age	< 50 yr	206	64.5	42.7	32.0	15.1	NS
	≥ 50 yr	150	68.7	46.3	38.0	18.7
1AFP ng/mL	< 400	130	68.4	49.2	37.7	19.2	P < 0.05
	≥ 400 ng/mL	154	62.3	32.5	26.0	9.1
Tumor size
10-15 cm		281	71.5	46.6	39.5	17.4	P < 0.05
> 15 cm		75	46.7	41.3	16.0	0
Capsule
Positive		270	71.0	48.1	44.0	21.9	P < 0.05
Negative		86	48.8	37.2	4.7	0
Extensive capsular infiltration
Positive		224	67.4	40.6	39.3	12.1	P < 0.05
Negative		46	93.5	84.8	76.1	69.6
Tumor thrombus in portal vein
Positive		62	38.7	22.6	6.5	0	P < 0.05
Negative		294	72.1	50.3	40.5	20.1
Satellite nodules
Positive		87	36.8	23.0	12.6	0	P < 0.01
Negative		269	75.8	52.8	41.6	21.9
Surgical resection margin
≤ 10 mm		251	64.1	40.2	34.3	13.9	NS
> 10 mm		105	71.4	58.1	35.2	22.9
Intraoperative blood loss
≤ 800 mL		260	69.6	43.8	33.5	15.4	NS
> 800 mL		96	57.3	50.0	37.5	19.8

¹n = 498.

Table 4 Multivariate analysis on prognostic factors associated with long-term survival in patients with huge hepatocellular carcinoma undergoing liver resection (n = 356)

Factor(variable)	Coefficient ofregression	Relativerisk	Standarderror	Walesstatistic	P
Capsule
Positive	-1.5152	1.3521	0.5078	9.543	< 0.05
Negative
Extensive capsular infiltration
Positive	-2.5237	1.4152	0.4035	10.321	< 0.05
Negative
Tumor thrombus in portal vein
Positive	-3.1012	2.4240	0.7122	7.543	< 0.05
Negative
Satellite nodules
Positive	-2.5158	1.7852	0.8055	7.257	< 0.05
Negative
Intraoperative blood loss
≤ 800 mL	-5.5257	1.5023	0.7211	15.15	< 0.05
> 800 mL