Significance of Hepatectomy for AJCC/UICC T3 Hepatocellular Carcinoma.

Background: It is difficult to treat the American Joint Committee on Cancer (AJCC)/International Union against Cancer (UICC) T3 hepatocellular carcinoma (HCC), curatively. Patients and Methods: We compared the clinicopathology of T3 group (n=44: T3a 25, T3b 19) with that of the T1 (n=257) or T2 group (n=120) and evaluated favorable conditions of hepatectomy for T3 HCC patients. Results: The T3 group had significantly higher hepatitis B surface antigen (HBsAg)-positive rates and better liver function. Infiltrative large tumors located beyond one sub-segment with intrahepatic metastasis were significantly more common. Significantly, more non-curative large hepatectomies with transarterial embolization were performed. There was no significant difference between T3 and 2 groups in 5-year disease-free survival (DFS) and survival (S). Tumor size more than 55 mm and serum albumin less than 3.5 g/dl were risk factors of hepatectomy for T3 HCC patients by multivariate analysis. Conclusion: Surgeons should resect AJCC/UICC T3 HCC lesions if the patient is able to tolerate surgery.