Comparison of tumor pathology with duration of survival of north american patients with hepatocellular carcinoma

Abstract

Background. Several of the large studies addressing prognosis and survival from hepatocellular carcinoma (HCC) have been from Europe and Asia, but only a few have emanated from North America. Survival statistics from other parts of the world may not be applicable to the North American population because of etiologic, demographic, cultural, lifestyle, and intangible differences. The current study investigated the survival experience and histologic correlates of North American patients with HCC and compared findings with similar studies from North America and other parts of the world. Methods. One thousand sixty‐three patients examined during a 14‐year period, met inclusion criteria for this study. Each patient was placed in one of three categories based on the duration of survival from date of diagnosis of HCC. Each tumor was examined histologically and classified according to World Health Organization criteria. Patient's sex and age at diagnosis were obtained from case records. Survival analyses and comparisons were performed using appropriate methods. Variables were tested for association using chi‐square tests and randomization tests as appropriate. Results. Age, sex, tumor growth pattern, Edmondson and Steiner's nuclear grades, mitotic index, and presence or absence of tumor giant cells or portal venous invasion, were found to have statistically significant (P < 0.05) relationships with the duration of patient survival. Significantly better survival was found to be associated with female sex, low nuclear grade, low mitotic index, age at diagnosis younger than 50 years, absence of giant cells, and absence of portal venous invasion. Conclusions. Certain histopathologic features of HCC may be useful for predicting patient survival and, thus, for empiric prognostication of these patients. Cancer 1995; 76:579–88.

Prognostic Value of Intratumoral Neutrophils in Advanced Gastric Carcinoma in a High-Risk Area in Northern Italy

“…In a multicenter study in northern Italy (23), a reduced gastric cancer risk was observed in women with later menopause and longer duration of fertile life. The favorable prognostic value of females, mainly younger patients, has been shown not only in gastric carcinoma (24), but also in tumors of other organs such as lung, liver, and colorectum (25)(26)(27).…”

Grading of small hepatocellular carcinomas (≤2 cm): correlation between histology,T2and diffusion-weighted imaging

“…The HCCs were graded according to a modified version of the Edmonson and Steiner classification. 22,23 Specifically, modified Edmondson and Steiner grades 1 and 2 were defined as well-differentiated, grade 3 as moderately differentiated and grade 4 as poorly differentiated. In tumours exhibiting several regions of differentiation, grading was established according to the highest grade observed.…”

Loss of 13q is associated with genes involved in cell cycle and proliferation in dedifferentiated hepatocellular carcinoma

“…18,19 We aimed to identify genes involved in the dedifferentiation of hepatocellular carcinoma. We previously showed that chromosomal instability increases parallel to dedifferentiation of hepatocellular carcinoma.…”

“…17 This is of clinical interest because morphological grading has been shown to correlate with survival. 18,19 Elucidation of the processes causing dedifferentiation of hepatocellular carcinoma is required because hepatocellular carcinoma dedifferentiated in more than half of patients within 7-34 months. 20,21 Investigations into the genomic and mRNA expression level have been attempted to provide insight into these processes, but a combined analysis has not yet been carried out.…”