Background & objective: Primary liver cancer (PLC) larger than 10 cm in diameter is called huge PLC. Huge PLC accounts for a number of patients at the time of diagnosis in clinical practice. The outcome of resection in these patients has not been clearly demonstrated. This study was to evaluate the outcome and determined the prognostic factors affecting long-term survival following hepatectomy for huge PLC.
Methods: One hundred and seventy-three patients with huge PLC who underwent hepatectomy from 1964 to 1993 were followed up to January 2003 and reviewed retrospectively. The factors affecting long-term survival were studied by univariate and multivariate analysis.
Results: The overall 3-, 5-, and 10-year survival rates were 31.9%, 21.8%, and 8.3%, respectively. Thirty-seven patients survived more than 5 years and 8 patients survived more than 10 years. Univariate analysis showed that sex, Child-Pugh classification, degree of coexisting cirrhosis and radical resection were significant prognostic factors. The Cox multivariate proportional hazard model indicated that independent prognostic factors for long-term survival were degree of coexisting cirrhosis and radical resection.
Conclusions: Hepatic resection for huge PLC offers the chance of long-term survival. It should be used to treat patients with huge PLC at first choice. Degree of coexisting cirrhosis and radical resection were the only two prognostic factors for long-term survival following hepatectomy for huge PLC.