Surgical Resection of Centrally Located Large Hepatocellular Carcinoma

Background: Centrally located large hepatocellular carcinoma (HCC) is a difficult issue insurgery. These HCCs can be treated by hemi-/extended or central hepatectomies. The aim of this study was to analyze the results of hemi-/extendedand central hepatectomies.Methods: One hundred and four patients with centrally-located large tumors were retrospectively reviewed. Patients were divided into group 1 (n = 41) withhemi-/extended hepatectomies, and group 2 (n = 63) with central hepatectomies. Characteristics were analyzed between groups and survival rateswere calculated.Results: Parenchyma resection was limited in group 2. The resection margin in 92.6%of group 2 patients was < 1 cm, compared with 78.9% of group 1 patients (p= 0.056). The 1- and 5-year disease-free survival rates were 50% and 38.9%for group 1, and 50% and 15% for group 2 (p = 0.279). The 1-, 5-year overallsurvival rates were 89.5% and 66.2% for group 1 and 87.5% and 53.1% forgroup 2 (p = 0.786). Cirrhosis, the preoperative aspartate aminotransferase(AST) level and lower resected liver weight were independent factorsimpairing survival.Conclusion: Hemi-/extended and central hepatectomies have comparable complicationrates and long-term survival rates for patients with centrally located largeHCC. Cirrhosis, the AST level and resected liver weight were independentfactors determining long-term survival.