Majority of patients with large size HCC (>10 cm) are not offered surgery as per Barcelona Clinic Liver Cancer (BCLC) criteria and hence, their outcomes are not well studied, especially from India, owing to a lower incidence.<\/p>\n\n\n\n
To analyze outcomes of surgery for large HCCs.<\/p>\n\n\n\n
This retrospective observational study included all patients who underwent surgery for large HCC from January 2007 to December 2017. The entire perioperative and follow up data was collected and analyzed.<\/p>\n\n\n\n
Nineteen patients were included. Ten were non-cirrhotic; 16 were BCLC grade A; one BCLC grade B; and two were BCLC C. Two cirrhotic and three non-cirrhotic underwent preoperative sequential trans-arterial chemoembolization and portal vein embolization. Right hepatectomy was the most commonly done procedure. The postoperative 30-day mortality rate was 5% (1\/19). Wound infection and postoperative ascites was seen in seven patients each. Postoperative liver failure was seen in five. Two cirrhotic and two non-cirrhotic patients had postoperative bile leak. The hospital stay was 11.9\u00b15.4 days (median 12 days). Vascular invasion was present in four cirrhotic and five non-cirrhotic patients. The median follow-up was 32 months. Five patients died in the follow-up period. Seven had recurrence and median recurrence free survival was 18 months. The cumulative recurrence free survival was 88% and 54%, whereas the cumulative overall survival was 94% and 73% at one and three years respectively. Both were better in non-cirrhotic; however, the difference was not statistically significant. The recurrence free survival was better in patients without vascular invasion and the difference was statistically significant (p=0.011).<\/p>\n\n\n\n
Large HCC is not a contraindication for surgery. Vascular invasion if present, adversely affects survival. Proper case selection can provide the most favorable survival with minimal morbidity.<\/p>","protected":false},"excerpt":{"rendered":"
Background: Majority of patients with large size HCC (>10 cm) are not offered surgery as per Barcelona Clinic Liver Cancer (BCLC) criteria and hence, their outcomes are not well studied, especially from India, owing to a lower incidence. Aim: To analyze outcomes of surgery for large HCCs. Methods: This retrospective observational study included all patients […]<\/p>","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_lmt_disableupdate":"no","_lmt_disable":"","footnotes":""},"categories":[9],"tags":[83,324,325],"class_list":["post-1330","post","type-post","status-publish","format-standard","hentry","category-original-article","tag-hepatectomy","tag-hepatocellular-carcinoma","tag-liver-failure"],"acf":[],"modified_by":null,"_links":{"self":[{"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/posts\/1330"}],"collection":[{"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/comments?post=1330"}],"version-history":[{"count":0,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/posts\/1330\/revisions"}],"wp:attachment":[{"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/media?parent=1330"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/categories?post=1330"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/tags?post=1330"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}