Morphological and histological features of resected hepatocellular carcinoma in cirrhotic patients in the west

Abstract

The pathological findings of 26 consecutive resections for hepatocellular carcinomas developing in cirrhotic patients were analyzed morphologically with a special interest in the presence of a capsule, vascular extension and satellite nodules. Tumor sizes varied from 2 to 11 cm. There were 20 expanding (76.9%) and six infiltrating tumors. Infiltrating tumors were significantly larger than expanding tumors (p less than 0.01). Histologically, the most common subgroups were the trabeculated pattern (65.4%) and the Edmonson-Steiner Type II (53.9%). Of the 20 expanding tumors, only six had direct spread in the liver parenchyma adjacent to the tumor (p less than 0.02). There was a significant relationship between the presence of a tumor extension in the distal portal branches and the presence of satellite nodules around the tumor (p less than 0.01). Survival at 6 months was significantly lower in patients with infiltrating (16.7%) than in those with expanding tumors (75%), (p less than 0.05). The present results indicate that pathological features of hepatocellular carcinomas in cirrhotic patients in Western countries are similar to those encountered in the East: (a) tumors are frequently encapsulated; (b) the propensity for the tumor to spread is closely related to the presence of a tumor capsule. This study suggests that a thorough preoperative search for the capsule should be made whenever resection of a hepatocellular carcinoma in a cirrhotic patient is contemplated.

Vascular Invasion, Satellite Nodules and Absence of Tumor Capsule Strongly Correlate with Disease-Free Survival and Long-Term Outcome in Patients Resected for Hepatocellular Carcinoma

“…Ohkubo et al [19] show that the size of the tumor influence the prognosis in patients with hepatocellular carcinoma, but emphasize that this parameter becomes statistically significant only for lesions with a diameter greater than 10 cm. Recurrence seems also correlate with peritumoral capsule [18] [20]. In our study the tumor dimensions seems to be correlated with the recurrence, with a better disease-free survival rates in patients with tumor smaller than 5 cm (p = 0.09).…”

Increased Extracellular Matrix Remodeling Is Associated With Tumor Progression in Human Hepatocellular Carcinomas

“…prognosis and improved survival of patients with HCC compared with nonencapsulated tumors. [30][31][32][33] Our data give new insights into this concept. Indeed, we show that nonencapsulated HCC had the highest expression of MMP2, MT1-MMP, TIMP2, and collagen I compared with encapsulated HCC.…”

Magnitude of Change in Alpha-Fetoprotein in Response to Transarterial Chemoembolization Predicts Survival in Patients Undergoing Liver Transplantation for Hepatocellular Carcinoma

“…An experienced liver pathologist examined all explanted liver specimens. The number of tumours, the maximum tumour diameter, the histologic grade (modified Edmonson criteria) 20 , and the presence of microvascular invasion were noted. Pathologic staging used in the study was based on the classification of the International Union Against Cancer and the American Joint Committee on Cancer 21 .…”