Histologic prognostic indicators in hepatocellular carcinoma

Abstract

Survival and histologic features were studied in 80 patients with proven hepatocellular carcinoma (HCC). The overall survival was 50% at 3.5 weeks with a statistically significant drop in mortality rate after 8.5 weeks. Patients with diffuse clear-cell pattern, focal clear-cell pattern, and no clear cells in their tumors had a 50% survival rate at 14 weeks, 6 weeks, and 3 weeks respectively; the differences in survival rates were statistically significant between any pair (p < 0.001). No correlation was found between survival and (1) cytologic differentiation, (2) histologic architecture, (3) degree of pleomorphism, or (4) presence of bile production, proteinaceous secretion, giant cells, or cytoplasmic hyaline bodies. Eosinophilic HCC with lamellar fibrosis was not observed in any of our materials. We concluded that the presence of clear cells was the only histologic feature of prognostic significance in our patients.

Edmondson grade predicts survival of patients with primary clear cell carcinoma of liver after curative resection: A retrospective study with long‐term follow‐up

“…Although some researchers claim that their prognosis is similar to that of CHCC or perhaps even worse, 10 more studies have reported PCCCL to have a better prognosis than CHCC. 3,4,7,[11][12][13] Our study confirmed their results and showed significantly higher 1-, 3-and 5-year survival rates in PCCCL patients in univariate analysis. Interestingly, multivariate analysis did not identify the rare histopathologic type of PCCCL as a significant prognostic factor.…”

Clear Cell Carcinoma of the Liver: A Comparative Immunohistochemical Study with Renal Clear Cell Carcinoma

“…Immunohistochemical stains are unnecessary when definitive foci of classical trabecular HCC with canaliculi, bile production and Mallory bodies, are present. But in small needle biopsies, or when these features are not present, immunohistochemical stains should be performed to differentiate HCC-CC, which appears to have a better prognosis than nonclear cell HCC, from metastatic clear cell tumors, which are known to have a poor prognosis (21,25). We recommend the Hepatocyte antibody (DAKO) as a screening immunostain in working-up a clear cell tumor in the liver when diagnostic histologic criteria of HCC are absent.…”

Characteristics of Hepatocellular Carcinoma in a High Arsenicism Area in Taiwan: A Case???Control Study

“…16 Clear cell type HCC also appears to carry a more favorable prognosis 32,33 and have a better responsiveness to hepatic artery chemotherapy than other subtypes of HCC, 34 although there is still controversy in this regard. 35 The incidence of clear cell change did not reach significance between patients from BFD endemic areas and the control areas, implying that arsenic may play a role in the later stages of hepatocarcinogenesis.…”