Ruiz E, Pineau P, Flores C, et al. - As per prior works, liver resection can be beneficial in a fraction of patients with hepatocellular carcinoma (HCC) > 10 cm. However, an effective decision-making tool is still missing to inform intervention in these patients. A comprehensive set of clinical data from 234 patients, who underwent liver resection for HCC >10 cm at the National Cancer Institute of Peru between 1990 and 2015, was analyzed and their survival was monitored. Following were identified as independent predictors of survival: cirrhosis, multifocality, macroscopic vascular invasion, and spontaneous tumor rupture and their integration was done into a nomogram model to predict long-term survival in patients with HCC >10 cm. Outcomes support the utility of this nomogram in assessing whether a patient with large HCC might truly benefit from liver resection, which is paramount in low- and middle-income countries where HCC is often diagnosed at advanced stages.