Abstract
BackgroundSmall hepatocellular carcinoma (sHCC) is a special subtype of HCC with the maximum tumor diameter ≤ 3 cm and excellent long-term outcomes. Surgical resection or radiofrequency ablation provides the greatest chance for cure; however, many patients still undergo tumor recurrence after primary treatment. To date, there is no clinical applicable method to assess biological aggressiveness in solitary sHCC.MethodsIn the current study, we retrospectively evaluated tumor necrosis of 335 patients with solitary sHCC treated with hepatectomy between December 1998 and 2010 from Sun Yat-sen University Cancer Center.ResultsThe presence of tumor necrosis was observed in 157 of 335 (46.9%) sHCC patients. Further correlation analysis showed that tumor necrosis was significantly correlated with tumor size and vascular invasion (P = 0.026, 0.003, respectively). The presence of tumor necrosis was associated closely with poorer cancer-specific overall survival (OS) and recurrence-free survival (RFS) as evidenced by univariate (P < 0.001; hazard ratio, 2.821; 95% CI, 1.643–4.842) and multivariate analysis (P = 0.005; hazard ratio, 2.208; 95% CI, 1.272–3.833). Notably, the combined model by tumor necrosis, vascular invasion and tumor size can significantly stratify the risk for RFS and OS and improve the ability to discriminate sHCC patients’ outcomes (P < 0.0001 for both).ConclusionsOur results provide evidence that tumor necrosis has the potential to be a parameter for cancer aggressiveness in solitary sHCC. The combined prognostic model may be a useful tool to identify solitary sHCC patients with worse outcomes.
Highlights
Small hepatocellular carcinoma is a special subtype of HCC with the maximum tumor diameter ≤ 3 cm and excellent long-term outcomes
We proposed to assess the prognostic value of tumor necrosis in solitary Small hepatocellular carcinoma (sHCC) following hepatectomy and to demonstrate whether tumor necrosis can be regarded as a parameter for sHCC aggressiveness
Patient characteristics Our current study identified 335 adult sHCC patients with long-term carriers of hepatitis B virus (HBV) and curative surgical resection
Summary
Small hepatocellular carcinoma (sHCC) is a special subtype of HCC with the maximum tumor diameter ≤ 3 cm and excellent long-term outcomes. Solitary sHCC is a special type of HCC with favorable long-term outcomes [7, 8]. Albeit surgical resection provides potentially curative therapies, disease recurrence is still frequently found in many patients postoperatively and less is known about the factors correlated with aggressive biological phenotype of sHCC [5,6,7,8]. It may be ideal to identify patients at high risk of tumor recurrence and/or poorer outcome, and to target close follow-up or postoperative adjuvant therapies in these subpopulations [9, 10]. The known clinicopathological factors for sHCC enable the identification and screening the patients at high risk, the reliable factors remain ill-defined [11, 12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
