Hepatectomy for huge hepatocellular carcinoma in 634 cases

AIM： To clarify the safety and feasibility of hepatectomy for huge hepatocellular carcinoma （HCC）. METHODS： A total of 4765 patients with HCC operated at Tongji Hospital were retrospectively studied, of them, 780 patients had huge HCC （10 cm or more in diameter）. Hepatectomy was carried out on 634 patients （81.2%）. The majority of the liver resection were major resections, and combined resection of the adjacent organs or structures was common （17.2%）. The liver resection was combined with portal vein thrombectomy in 139 patients （21.9%）. RESULTS： Postoperative complications were common （26.8%） and required another laparotomy to prevent the complications in 5 patients （0.8%）. The 30-d mortality was 2.2%. The main causes of postoperative deaths were liver failure （n = 9）, postoperative bleeding （n = 4） and septic complication （n = 1）. The 3-, 5- and 10-year survival rates after liver resection were 35.1%, 18.2% and 3.5%, respectively. CONCLUSION： Hepatectomy for huge HCC is safe and effective. It should be used to treat patients with low surgical risks and resectable tumours.