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Cirrhotomimetic hepatocellular carcinoma: experience of a single institution and review of the literature.

ABSTRACT: Cirrhotomimetic hepatocellular carcinoma is a recognized pattern exhibiting cirrhosis-like growth and a reputation for evading pretransplant detection. Five cases encountered from our institution were retrospectively reviewed. Clinicopathologic and literature reviews were performed. All five patients were male, aged 50-66. Diffuse, innumerable nodules were seen grossly, exhibiting predominantly well-to-moderate differentiation with pseudoglandular and trabecular patterns microscopically. By immunohistochemistry, the tumor was diffusely positive for Glypican-3, showed sinusoidal capillarization by CD34 and slightly increased MIB-1 proliferation index. At up to 3.25 years of follow-up, our cohort of cirrhotomimetic hepatocellular carcinoma had no recurrence in 60% (3/5), solitary recurrence in 20% (1/5) and one patient had died of disease in 20% (1/5). Literature review suggests that these tumors recurred at a frequency of 50% (19 of 38 patients).

SUBMITTER: Xiong MJ

PROVIDER: S-EPMC7907961 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Cirrhotomimetic hepatocellular carcinoma: experience of a single institution and review of the literature.

Xiong Meng-Jun MJ Patel Chirag R CR Manne Upender U Al Diffalha Sameer S

Hepatic oncology 20200821 1

Cirrhotomimetic hepatocellular carcinoma is a recognized pattern exhibiting cirrhosis-like growth and a reputation for evading pretransplant detection. Five cases encountered from our institution were retrospectively reviewed. Clinicopathologic and literature reviews were performed. All five patients were male, aged 50-66. Diffuse, innumerable nodules were seen grossly, exhibiting predominantly well-to-moderate differentiation with pseudoglandular and trabecular patterns microscopically. By immu ...[more]

PMID: 33680429

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Project description:Simple Summary For 35 patients with recurrent HCC after primary hepatectomy and 67 patients with recurrent HCC after locoregional therapies, surgical and oncological outcomes were examined. Pathologic review revealed 30 patients with locally recurrent HCC after locoregional therapy (LR-HCC). Background liver function was significantly worse in patients with recurrent HCC after locoregional therapy. Serum levels of AFP and AFP-L3 were significantly higher in patients with LR-HCC. Perioperative morbidities were observed in significantly more patients with recurrent HCC after locoregional therapies. Long-term outcomes of recurrent HCC after locoregional therapies were worse than those after hepatectomy, though there was no prognostic difference according to the recurrence patterns after locoregional therapies. Multivariate analyses showed that prognostic factors for resected recurrent HCC were previous locoregional therapy, multiple HCCs, and portal venous invasion, whereas LR-HCC was not a prognostic factor. In conclusion, salvage hepatectomy for LR-HCC showed worse surgical outcomes but a favorable prognosis. Abstract Surgical and oncological outcomes of hepatectomy for recurrent hepatocellular carcinoma (HCC) after locoregional therapy, including locally recurrent HCC (LR-HCC), were examined. Among 273 consecutive patients who underwent hepatectomy for HCC, 102 with recurrent HCC were included and retrospectively reviewed. There were 35 patients with recurrent HCC after primary hepatectomy and 67 with recurrent HCC after locoregional therapies. Pathologic review revealed 30 patients with LR-HCC. Background liver function was significantly worse in patients with recurrent HCC after locoregional therapy (p = 0.002). AFP (p = 0.031) and AFP-L3 (p = 0.033) serum levels were significantly higher in patients with LR-HCC. Perioperative morbidities were significantly more frequently observed with recurrent HCC after locoregional therapies (p = 0.048). Long-term outcomes of recurrent HCC after locoregional therapies were worse than those after hepatectomy, though there was no prognostic difference according to the recurrence patterns after locoregional therapies. Multivariate analyses showed that prognostic factors for resected recurrent HCC were previous locoregional therapy (hazard ratio [HR] 2.0; p = 0.005), multiple HCCs (HR 2.8; p < 0.001), and portal venous invasion (HR 2.3; p = 0.001). LR-HCC was not a prognostic factor. In conclusion, salvage hepatectomy for LR-HCC showed worse surgical outcomes but a favorable prognosis.

Dataset Information

Cirrhotomimetic hepatocellular carcinoma: experience of a single institution and review of the literature.

Publications

Cirrhotomimetic hepatocellular carcinoma: experience of a single institution and review of the literature.

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