CHARACTERISTIC DIFFERENCES OF HEPATOCELLULAR-CARCINOMA IN JAPAN, WITHSPECIAL REFERENCE TO LIVER WEIGHT AT AUTOPSY

Background/Aims: Liver weight at autopsy in patients with hepatocellul ar carcinoma (HCC) has been found to differ by geographic region. The clinicopathological characteristics of HCC in relation to liver weight at autopsy have not been reported for Japanese cases. Methodology: Fr om 1980 to 1992, a total of 107 consecutive HCC autopsy cases were stu died. Seven cases were excluded (5 surgically resected cases and 2 cas es of occult type HCC (Berman) which were diagnosed at autopsy for the first time). The 100 cases of HCC were divided into 4 groups accordin g to liver weight at autopsy: less than 999g (group A, n=15, 15%); 100 0-1999g (group B, n=50, 50%); 2,000-2,999g (group C, n=20, 20%); and m ore than 3,000g (group D, n=15, 15%). Various clinical and pathologica l findings, including age, sex, hepatitis B surface antigen (HBsAg) st atus, history of blood transfusions, treatment, cause of death, underl ying liver disease, survival after diagnosis, tumor size, macroscopic findings, microscopic findings, splenic weight and liver weight were s tudied. Results: Significant differences between, groups were found in sex (p<0.01), underlying liver disease (p<0.001), tumor size (p<0.000 1), microscopic findings (p<0.001) and survival (p<0.01). The lowest l iver weight group (group A) had a significantly longer mean survival r ate than the other three groups (p<0.001). Conclusions: These results showed that 15% of HCC occurred in large size livers (more than 3,000g ), 15% occurred in small size livers less than 999g) and 70% occurred in livers between 1,000g and 2,999g, and that tumor size (p<0.0001) an d microscopic findings (p<0.001) were the major determinants of liver weight in HCC patients. The total liver volume reflected by liver weig ht in HCC cases may be valuable for the assessment of the clinicopatho logical features of HCC and its prognosis.