Clinical and Pathologic Characteristics of Hepatocellular Carcinoma following Resection according to the Tumor Size
A tumor size of hepatocellular carcinoma (HCC) has been known to be an important prognostic factor after resection and it is considered to be closely correlated with vascular invasion of HCC. We aimed this study to elucidate the outcomes according to some previously studied size criteria and the relationship between the size criteria and clinicopathologic parameters after surgical resection in a single center. Between Apr 2001 and Apr 2008, 307 patients with pure HCC (no combined intrahepatic cholangiocarcinoma) underwent first hepatic resection in a single center without preoperative transcatheter arterial chemoembolization (TACE). The 307 patients’ clinicopathologic data were retrospectively investigated. The tumor size criteria (2cm, 5cm and 10cm) were predictive factors for survival in univariate analysis, but not in multivariate analysis. Vascular invasion, tumor necrosis, and absence of tumor capsule were proved to be independent significant factors for overall survival. Among them, vascular invasion and tumor necrosis showed significant correlation with tumor size. On the other hand, tumor capsule did not show any correlation with tumor size. Tumor size should be further subdivided for T-classification of the AJCC/UICC staging system to predict prognosis more accurately. Considering that the AJCC/UICC staging system is a histopathologic staging system and tumor capsule was an independent significant prognostic factor irrespective of tumor size, tumor capsule should be included in T-classification of the AJCC/UICC staging system for more accurate prediction of survival.
hepatocellular carcinoma, hepatectomy, tumor size, prognostic factor, vascular invasion, spontaneous tumor necrosis, tumor capsule
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