Diffuse-Type Hepatoma: A Grave Prognostic Marker
| Autor: | Janaka de Silva, C.A.H. Liyanage, Bhagya Gunetilleke, Subani Priyangika Jayatunge, Anuradha S Dassanayake, Rohan C. Siriwardana, Madunil A. Niriella |
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| Rok vydání: | 2017 |
| Předmět: |
Hepatitis
medicine.medical_specialty Pathology Original Paper business.industry Pharmaceutical Science Cancer medicine.disease Gastroenterology digestive system diseases Internal medicine Hepatocellular carcinoma Nonalcoholic fatty liver disease medicine T-stage Stage (cooking) business Alpha-fetoprotein Survival rate |
| Zdroj: | Gastrointestinal tumors. 4(1-2) |
| ISSN: | 2296-3774 |
| Popis: | Background: Data on diffuse-type hepatocellular carcinoma (HCC) are rare. HCC in Sri Lanka is rising, and the majority is related to nonalcoholic fatty liver disease. This study was planned to compare nodular- and diffuse-type HCC in this cohort. Methods: CT scans of 227 patients with HCC negative for infective hepatitis were analyzed and grouped as nodular and diffuse from July 2011 to July 2014. Diffuse-type cancer was defined as a tumor without convex/distinct margin, diffusely infiltrating the hepatic parenchyma. There were 45 (20%) cases. The baseline liver functions, etiology, treatment, and the outcome were compared with nodular-type cancers. Stage III diffuse cancers were matched with 2 stage III nodular cancers looking at the T stage and background liver. Results: There was no difference in the age (63 vs. 62 years, p = 0.937) and gender. Diffuse cancers had a low BMI (24 vs. 22, p = 0.009), a higher alpha fetoprotein (AFP) level (p < 0.001), a higher incidence of major vascular invasion (14 vs. 80%, p < 0.001), and a history of significant alcohol consumption (39 vs. 67%, p = 0.001). The baseline liver functions were similar in diffuse and nodular cancers. A large proportion (27 vs.77%, p < 0.001) of diffuse cancers were not candidates for active treatment. Overall survival was poor in the diffuse type (4.7 vs. 25 months, p < 0.001). Diffuse-type stage III cancers had a poor survival compared to matched nodular cancers (2.5 vs. 15.8 months, p = 0.001). Conclusion: HCC without a background of infective hepatitis were common in our cohort. These tumors are associated with high AFP levels, major vascular invasion, and a poor prognosis. |
| Databáze: | OpenAIRE |
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