{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T11:42:44Z","timestamp":1774006964895,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2009,12,24]],"date-time":"2009-12-24T00:00:00Z","timestamp":1261612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2010,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Optimal management of large (&gt;5\u2009cm) hepatocellular carcinoma (HCC) remains controversial. We sought to determine the factors associated with recurrence and survival for patients with large HCC following hepatectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An analysis of a combined prospective database from two tertiary care centers was performed on consecutive patients who underwent hepatectomy for HCC\u2009&gt;\u20095\u2009cm. Univariate and multivariate analyses were performed to determine factors associated with recurrence, disease\u2010free (DFS) and overall survival (OS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010eight patients were identified: 32 (41%) had hepatic fibrosis. Forty\u2010six patients (59%) underwent a major hepatectomy with a morbidity rate of 41% and a mortality rate of 13%. Fibrosis was associated with male gender (<jats:italic>P<\/jats:italic>\u2009=\u20090.045), hepatitis C (<jats:italic>P<\/jats:italic>\u2009=\u20090.003), higher Child\u2010Pugh (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001) and Okuda score (<jats:italic>P<\/jats:italic>\u2009=\u20090.002), smaller tumors (6.25\u2009cm vs. 10.5\u2009cm; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), positive\u2010margin resection (<jats:italic>P<\/jats:italic>\u2009=\u20090.01), and death (<jats:italic>P<\/jats:italic>\u2009=\u20090.047). Factors associated with recurrence include tumor multifocality (<jats:italic>P<\/jats:italic>\u2009=\u20090.03) and vascular invasion (<jats:italic>P<\/jats:italic>\u2009=\u20090.02). Predictors of OS include multifocal tumors (<jats:italic>P<\/jats:italic>\u2009=\u20090.05), margin status (<jats:italic>P<\/jats:italic>\u2009=\u20090.02), vascular invasion (<jats:italic>P<\/jats:italic>\u2009=\u20090.01), and treatment complications (<jats:italic>P<\/jats:italic>\u2009=\u20090.004). The median overall DFS and OS were 12 and 20 months, respectively. Fibrosis had no impact on DFS (<jats:italic>P<\/jats:italic>\u2009=\u20090.24) or OS (<jats:italic>P<\/jats:italic>\u2009=\u20090.20).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For patients with HCC larger than 5\u2009cm, tumor\u2010related factors predict outcomes and survival. J. Surg. Oncol. 2010;101:105\u2013110. \u00a9 2009 Wiley\u2010Liss, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.21461","type":"journal-article","created":{"date-parts":[[2009,12,24]],"date-time":"2009-12-24T11:16:32Z","timestamp":1261653392000},"page":"105-110","source":"Crossref","is-referenced-by-count":38,"title":["Factors associated with recurrence and survival following hepatectomy for large hepatocellular carcinoma: A multicenter analysis"],"prefix":"10.1002","volume":"101","author":[{"given":"Suzanne C.","family":"Schiffman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles E.","family":"Woodall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Kooby","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert C.G.","family":"Martin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles A.","family":"Staley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasili","family":"Egnatashvili","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly M.","family":"McMasters","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles R.","family":"Scoggins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,1,15]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2004.12.009"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.3322\/canjclin.57.1.43"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.SLA.0000059988.22416.F2"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199903113401001"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/jso.20260"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200210000-00001"},{"key":"e_1_2_1_8_2","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1097\/01.sla.0000090449.87109.44","article-title":"Liver resection as a bridge to transplantation for hepatocellular carcinoma on cirrhosis: A reasonable strategy?","volume":"238","author":"Azoulay AR","year":"2003","journal-title":"Ann Surg"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(00)00700-6"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199109000-00005"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2005.04.002"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(02)01163-8"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-007-9518-1"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2003.03.072"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510250116"},{"key":"e_1_2_1_16_2","first-page":"1","article-title":"Is hepatic resection for large or multinodular hepatocellular carcinoma justified? 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