Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. May 27, 2021; 13(5): 476-492
Published online May 27, 2021. doi: 10.4240/wjgs.v13.i5.476
Liver resection for hepatocellular carcinoma larger than 10 cm: A multi-institution long-term observational study
Chao-Wei Lee, Ming-Chin Yu, Chih-Chi Wang, Wei-Chen Lee, Hsin-I Tsai, Feng-Che Kuan, Chun-Wei Chen, Yi-Chung Hsieh, Hsing-Yu Chen
Chao-Wei Lee, Ming-Chin Yu, Wei-Chen Lee, Division of General Surgery, Department of Surgery, Linkou Chang Gung Memorial Hospital, Guishan 333, Taoyuan, Taiwan
Chao-Wei Lee, Ming-Chin Yu, Wei-Chen Lee, Hsin-I Tsai, Chun-Wei Chen, Yi-Chung Hsieh, College of Medicine, Chang Gung University, Guishan 333, Taoyuan, Taiwan
Chao-Wei Lee, Ming-Chin Yu, Hsin-I Tsai, Hsing-Yu Chen, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Guishan 333, Taoyuan, Taiwan
Ming-Chin Yu, Department of Surgery, New Taipei Municipal Tu-Cheng Hospital (Built and Operated by Chang Gung Medical Foundation), Tu-Cheng 236017, New Taipei City, Taiwan
Chih-Chi Wang, Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
Chih-Chi Wang, Division of General Surgery, Department of Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
Hsin-I Tsai, Department of Anesthesiology, Linkou Chang Gung Memorial Hospital, Guishan 333, Taoyuan, Taiwan
Feng-Che Kuan, Department of Hematology and Oncology, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
Chun-Wei Chen, Yi-Chung Hsieh, Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Guishan 333, Taoyuan, Taiwan
Hsing-Yu Chen, Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Taoyuan Chang Gung Memorial Hospital, Guishan 33378, Taoyuan, Taiwan
Hsing-Yu Chen, School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Guishan 333, Taoyuan, Taiwan
Author contributions: Lee CW designed the study, conducted the research, and drafted the manuscript; Yu MC, Wang CC, and Lee WC performed the operations, formulated the concept, supervised the study, and revised the manuscript; Tsai HI and Kuan FC confirmed the statistics, interpreted the data, and revised the manuscript; Chen CW and Hsieh YC collected the data and analyzed the results; Chen HY coordinated the entire study, performed the statistics, and approved the manuscript; All authors read and approved the final manuscript.
Supported by Chang Gung Memorial Hospital, No. CMRPG3J1691.
Institutional review board statement: This study was approved by the Institutional Review Boards (No. 202000608B0) of Chang Gung Memorial Hospital. For retrospective study, informed consent was waived according to our institutional guideline.
Conflict-of-interest statement: Authors have no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hsing-Yu Chen, MD, Associate Professor, Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Taoyuan Chang Gung Memorial Hospital, No. 123 Dinghu Road, Guishan District, Guishan 33378, Taoyuan, Taiwan. b8705016@gmail.com
Received: January 29, 2021
Peer-review started: January 29, 2021
First decision: March 6, 2021
Revised: March 13, 2021
Accepted: April 28, 2021
Article in press: April 28, 2021
Published online: May 27, 2021
Processing time: 111 Days and 22.6 Hours
Core Tip

Core Tip: By analyzing the data from one of the largest clinical databases worldwide, the current study demonstrated an improving surgical outcome for hepatocellular carcinoma ≥ 10 cm. Under selected conditions, surgery is better than transarterial chemoembolization in terms of disease control and survival. Due to inferior survival for HCC ≥ 10 cm, a subclassification within T1 stage should be considered.