[Large primary liver cancer (> 10 cm)- diagnosis and surgical treatment].

BACKGROUND: Primary liver cancer (PLC) over 10 cm. in diameter at the time of diagnosis continues to account for a number of patients undergoing hepatic resection. This study evaluated the clinicopathological features and outcome following surgery for large PLC. METHODS: Between January 1991 and December 2002 , 105 patients were operated, 68 of them (64.7%) the size of tumor was > 10 cm. Forty-five patients (66.2%) with a large PLC(greater than 10 cm) were resected and studied retrospectively. They were compared with 27 patients who had tumor less than 10 cm. They were 31 men and 14 women of mean age 53,8 (from 1 to 78 years). Cirrhosis had 13 patients (28,9%) - Child A- 10, Child B - 3. RESULTS: Surgical procedures were: major resections in 33 patients and minor resections in 12. Eight patients (17,7%) died by the 30-th day. 16 patients had postoperative complications - 6 patients developed liver failure. The 1-, 2-, 3- and 5-year overall survival rates were 68%, 43%, 22% , 2,2% respectively. CONCLUSION: Large primary liver cancer can be safely resected when cirrhosis is absent. Liver cirrhosis is contraindication for major hepatic resection. The lack of cirrhosis increases resectability and decreases morbidity and mortality.