Large hepatocellular carcinoma (HCC) is one of the most common malignancies and was mistaked as "advanced and unresectable" . Liver resection is still the best curable treatment for HCC.The resection of large HCC is very difficult, which seriously restrict the progress of liver surgery.Our study proved that solitary large HCC (SLHCC) has unique clinicopathological and molecular biological characteristics.No matter how big the tumor size is, it belongs to early stage if there is no vascular invasion.Liver resection should be aggressively recommended for the patients with SLHCC, in which they can obtain good outcome, with 40% 5-year survival rate.We has also defined the borderline resectable hepatocellular carcinoma, and suggested that strictly master and correctly judge the surgical indications, syntheticly evaluate the surgical safety and patient's tolerability for liver resection.After that, with hands of experienced surgeons, liver resection for SLHCC can be safely and reliablely performed.
大肝癌临床十分常见，长期被归为"晚期、不可切除"的肝癌。肝切除迄今仍是肝癌最佳的治疗手段。大肝癌的外科治疗较为困难，严重制约了肝癌外科治疗水平的进一步提高。但孤立性大肝癌具有独特的临床病理学特征与分子病理学特征和相对好的肿瘤生物学特性。若无血管侵犯，无论肿瘤大小均属早期。虽然瘤体巨大、手术切除困难，风险大，但其手术效果佳，5年总体生存率可达40%左右，患者生存获益明显。故对于孤立性大肝癌应倡导积极开展手术切除，不要轻易放弃手术。作者定义了临界可切除肝癌，对此类患者的治疗要严格把握并正确判断手术适应证，综合评估患者的手术安全性与耐受性，熟练掌握孤立性大肝癌的手术技巧。对于有经验的外科医生，开展孤立性大肝癌与临界可切除肝癌的手术切除是安全有效的。.
Keywords: Borderline resectable hepatocellular carcinoma; Hepatectomy; Indication; Liver neoplasms; Solitary large hepatocellular carcinoma.