Objective: To investigate the clinicopathological features and the safety of surgical treatment of large hepatocellular carcinoma (HCC).
Methods: A total of 316 HCC patients undergoing hepatectomy at our hospital from December 2005 to December 2008 were divided into HCC > 10 cm (large HCC) group (n = 119) and HCC < or = 10 cm group (n = 197). The clinicopathological data and surgical outcomes were compared between two groups.
Results: The HCC > 10 cm group had a higher rate of symptoms and physical findings than the HCC < or = 10 cm group. Compared with HCC < or = 10 cm group, intrahepatic metastasis, vascular invasion, adjacent organ invasion and poorly differentiated tumor were more common in HCC > 10 cm group. The preoperative serum levels of alpha-fetoprotein, aspartate aminotransferase and alkaline phosphatase were higher in HCC > 10 cm group. The patients with HCC > 10 cm received more major hepatectomies, suffered more intraoperative blood loss, had greater blood transfusion requirements and needed a longer operative duration. However, the incidences of postoperative complications and mortality rate were similar in two groups.
Conclusion: Large HCC is characterized by more clinical manifestations, higher incidences of vascular invasion and adjacent organ invasion, and worse histological grades. Surgical resection for large HCC is both safe and feasible.