Edmondson-Steiner grade: A crucial predictor of recurrence and survival in hepatocellular carcinoma without microvascular invasio

• Published in: Pathology, research and practice research and practice, 2017-07, Vol.213 (7), p.824-830
• Main Authors: Zhou, Li, Rui, Jing-An, Zhou, Wei-Xun, Wang, Shao-Bin, Chen, Shu-Guang, Qu, Qiang
• Format: Article
• Language: English
• Subjects: Adult; Aged; alpha-Fetoproteins - analysis; Carcinoma, Hepatocellular - blood; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Chi-Square Distribution; China; Decision Support Techniques; Disease Progression; Disease-Free Survival; Edmondson-Steiner grade; Female; Hepatectomy; Hepatocellular carcinoma; Humans; Kaplan-Meier Estimate; Liver Neoplasms - blood; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Logistic Models; Male; Microvascular invasion; Middle Aged; Multivariate Analysis; Neoplasm Grading - methods; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Predictive Value of Tests; Proportional Hazards Models; Recurrence; Risk Factors; Survival; Time Factors; Treatment Outcome; Tumor Burden; Young Adult
• ISSN: 0344-0338; 1618-0631
• DOI: 10.1016/j.prp.2017.03.002

Microvascular invasion (MVI), an important pathologic parameter, has been proven to be a powerful predictor of long-term prognosis in hepatocellular carcinoma (HCC). However, prognostic factors in HCC without MVI remain unknown. The present study aimed to identify the risk factors of recurrence and poor post-resectional survival in this type of HCC. A total of 109 patients with MVI-absent HCC underwent radical hepatectomy were enrolled. The influence of clinicopathologic variables on recurrence and patient survival was assessed using univariate and multivariate analyses. Chi-square test found that Edmondson-Steiner grade and satellite nodule were significantly associated with recurrence, while the former was the single marker for early recurrence. Stepwise logistic regression analysis demonstrated the independent predictive role of Edmondson-Steiner grade for recurrence. On the other hand, Edmondson-Steiner grade, serum AFP level and satellite nodule were significant for overall and disease-free survival in univariate analysis, whereas tumor size was linked to disease-free survival. Of the variables, Edmondson-Steiner grade, serum AFP level and satellite nodule were independent indicators. Edmondson-Steiner grade, a histological classification, carries robust prognostic implications for all the endpoints for prognosis, thus being potential to be a crucial prognosticator in HCC without MVI.