Prognostic factors of solitary large hepatocellular carcinoma: the importance of differentiation grade

Eur J Surg Oncol. 2011 Jun;37(6):521-5. doi: 10.1016/j.ejso.2011.03.137. Epub 2011 Apr 29.

Abstract

Aims: Solitary large hepatocellular carcinoma (SL-HCC), a novel subtype with relative good prognosis, has recently been defined. However, the concept has not been validated. Besides, prognostic factors of SL-HCC remain unknown. The present study is designed to address the issues.

Materials and methods: Clinicopathological variables and survival of consecutive 85 patients with SL-HCC after curative resection are compared with those of 48 patients with small HCC (SHCC). The prognosticators of SL-HCC are also evaluated.

Results: Disease-free survival of SL-HCC is similar with that of SHCC, whereas significant poorer overall survival is observed in SL-HCC than that in SHCC, accompanied by more frequent vascular invasion, later TNM stage and potentially higher Edmondson-Steiner grade. Vascular invasion, Edmondson-Steiner grade, TNM stage and preoperative AFP level impact overall and/or disease-free survival of SL-HCC, but only Edmondson-Steiner grade is independent. Additionally, differences in both overall and disease-free survival between SL-HCC with Edmondson-Steiner grade I-II and SHCC are all not significant.

Conclusions: Factors predictive for prognosis of SL-HCC are all tumor-related. The involvement of differentiation grade might be helpful for further distinguishing a particularly good outcome in SL-HCC.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Carcinoma, Hepatocellular / pathology*
  • Carcinoma, Hepatocellular / surgery
  • Cell Differentiation
  • Disease-Free Survival
  • Female
  • Hepatectomy
  • Humans
  • Liver Neoplasms / pathology*
  • Liver Neoplasms / surgery
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Predictive Value of Tests
  • Prognosis
  • Risk Factors
  • Survival Analysis