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

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 a...

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Bibliographic Details
Published in:European journal of surgical oncology 2011-06, Vol.37 (6), p.521-525
Main Authors: Zhou, L, Rui, J.-A, Wang, S.-B, Chen, S.-G, Qu, Q
Format: Article
Language:English
Subjects:
Aged
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - surgery
Cell Differentiation
Curative resection
Disease-Free Survival
Edmondson–Steiner grade
Female
Hematology, Oncology and Palliative Medicine
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
Small hepatocellular carcinoma
Solitary large hepatocellular carcinoma
Surgery
Survival Analysis
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Summary: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 Clinicopatholical 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.
ISSN:0748-7983
1532-2157
DOI:10.1016/j.ejso.2011.03.137