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Objective: To analyze the prognostic factors in patients after surgical resection of a huge primary liver cancer (HPLC)., Methods: Clinical and follow-up data of 69 cases of huge HPLC treated in our hospital from July 2001 to July 2008 were retrospectively analyzed. Sixteen clinicopathologic factors possibly influencing the survival were selected, and multivariate analysis of these parameters was performed using the Cox proportional hazards model., Results: The cumulative 1-, 3-, 5-year survival rates of 58 patients were 58.2%, 31.4% and 12.3%, respectively. Univariate analysis showed that radical resection, intrahepatic metastasis, vascular invasion and degree of hepatic cirrhosis significantly affect the postoperative survival. The Cox multivariate analysis indicated that radical resection, intrahepatic metastasis and degree of hepatic cirrhosis are independent prognostic factors., Conclusions: Surgical resection is a major and active treatment for huge HPLC. The therapeutic efficacy depends on intrahepatic metastasis, degree of hepatic cirrhosis and radical resection. Aggressive treatment and prevention on postoperative intrahepatic recurrence and metastasis is an important strategy to improve the survival of patients with huge HPLC.

Objective: To investigate the diagnostic and therapeutic approach of solitary necrotic nodule of the liver (SNNL)., Methods: Fifteen cases were diagnosed as SNNL from June 1999 to December 2005. The clinical characteristics, imaging findings, diagnosis and treatment were analyzed with related literature retrospectively., Results: The patients manifested abdominal pain and discomfort in 7 cases (46.7%), fever in 1 case (6.7%), debilitation in 1 case (6.7%). Lesions were screened as hypoechogenic patterns in B ultrasound, and CT scan confirmed that the lesion appeared slightly hypodense compared with the normal liver parenchyma without detectable enhanced graphic phases. No significant enhancement was on dynamic magnetic resonance imaging study. All of the nodules demonstrated hypointense and isointense signal relative to parenchyma of liver on both T1 and T2-weighted images. Histologically, the lesion composed mainly of coagulative necrosis with a homogeneous periphery, and the central zone had a rough patchy appearance with cellular debris. The coagulative necrosis was surrounded by a thin boundary of collagen fibers with scanty mononuclear, lymphocyte, plasmocyte inflammatory cells and elastic fibers. Preoperative laboratory examinations showed hepatic function slightly abnormal in 3 patients, and AFP level was normal in all patients. Diagnosis of SNNL was established in 4 cases (26.7%) preoperatively. All patients underwent liver resection with no recurrence within 3 months to 6 years follow-up., Conclusions: Preoperative diagnosis of SNNL can be established via comprehensive analysis of clinical characteristics and imaging findings. Liver resection is the optimal therapeutic approach.