Li Wei, You Xuemei, Li Lequn, Zhong Jianhong
Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021 China.
Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021 China; Email:
Zhonghua Yi Xue Za Zhi. 2015 Oct 13;95(38):3115-8.
To investigate the safety and efficacy of hepatic resection for those patients with large/multinodular hepatocellular carcinoma (HCC) or those involving macrovascular invasion (MVI).
PubMed was systematically searched for studies examining the safety and efficacy of hepatic resection for treatment of HCC involving a single large tumor (>5 cm) or multiple tumors (>2), or those involving MVI.
The identified 52 studies involving 14 922 patients that investigated the use of hepatic resection for large/multinodular HCC, and 25 studies with 4 412 patients that investigated hepatic resection for HCC with MVI. Median in-hospital mortality of patients with either type of HCC was significantly lower in Asian studies (2.7%) than in non-Asian studies (7.3%, P<0.001). Median overall survival rate was significantly higher for all Asian patients with large/multinodular HCC than for all non-Asian patients both at the time of 1 year (81% vs 65%, P<0.001) and 5 years (42% vs 32%, P<0.001). However, median overall survival rate was similar for Asian and non-Asian patients with HCC involving MVI at the time of 1 year (50% vs 52%, P=0.46) and 5 years (18% vs 15%, P=0.95). There was an increasing trend in 5-year overall survival in patients with either type of HCC.
Hepatic resection is reasonably safe and effective for the treatment of large/multinodular HCC and HCC with MVI. The available evidence argues for expanding the indications for hepatic resection in official treatment guidelines.
