Characteristics of atypical large well-differentiated hepatocellular carcinoma: a specific subtype of hepatocellular carcinoma?
| Autor: | Yun S. Chun, Timothy E. Newhook, Jean Nicolas Vauthey, Yoshikuni Kawaguchi, Ching Wei D. Tzeng, Masayuki Okuno, Thomas A. Aloia, Mario De Bellis, Ahmed Kaseb, Katharina Joechle, Junichi Shindoh |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Cirrhosis Carcinoma Hepatocellular medicine.medical_treatment Gastroenterology Disease-Free Survival Malignant transformation 03 medical and health sciences Young Adult 0302 clinical medicine Internal medicine 80 and over Medicine Hepatectomy Humans neoplasms Aged Retrospective Studies Aged 80 and over Hepatology business.industry Carcinoma Fatty liver Liver Neoplasms Hepatocellular Hepatocellular adenoma Middle Aged medicine.disease Prognosis digestive system diseases Survival Rate Treatment Outcome 030220 oncology & carcinogenesis Hepatocellular carcinoma Etiology 030211 gastroenterology & hepatology Female business Well Differentiated Hepatocellular Carcinoma |
| Zdroj: | HPB : the official journal of the International Hepato Pancreato Biliary Association. 22(4) |
| ISSN: | 1477-2574 |
| Popis: | Hepatocellular carcinoma (HCC) de-differentiation is thought to correlate with size, therefore well-differentiated HCC ≥3 cm are considered rare and not fully understood.Patients who underwent hepatectomy for HCC between 1998-2016 were retrospectively analyzed. Patient's characteristics and recurrence-free (RFS) and overall (OS) survival were compared between those with atypical- (well-differentiated-HCC ≥3 cm) and typical-HCC (moderate-to-poorly-differentiated HCC ≥3 cm).Of 176 patients included in this study, 37 (21%) had atypical-HCC. Patients with atypical-HCC were less likely to be Asian ethnicity (3% vs. 17%, p = 0.062), have lower rate of viral infection (14% vs. 43%, p = 0.003), cirrhosis (8% vs. 27%, p = 0.015). The tumors were less likely to demonstrate vascular invasion (30% vs. 59%, p = 0.002), and were associated with a lower alpha-fetoprotein level (3.5 ng/ml vs. 33.2 ng/ml, p 0.001). Patients with atypical-HCC had a longer RFS (5-y RFS: 58.3% vs. 35.7%, p = 0.016) and OS (5-y OS: 79.1% vs 53.3%, p = 0.029) as compared to those with typical-HCC following univariate analysis, however this did not appear following multivariate analysis.Patients with atypical-HCC have different characteristic in terms of epidemiology, etiology, cirrhosis and vascular invasion as compared to typical-HCC. The etiology of atypical-HCC may be non-alcoholic fatty liver disease-related and/or malignant transformation of hepatocellular adenoma. |
| Databáze: | OpenAIRE |
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