PROGNOSTIC-SIGNIFICANCE OF PATHOLOGICAL FEATURES OF HEPATOCELLULAR-CARCINOMA - A MULTIVARIATE-ANALYSIS OF 278 PATIENTS

Background. In patients with hepatocellular carcinoma, surgical resect ion may offer a chance of cure. However, tumor recurrence is not infre quent after resection. Methods. To identify the pathologic factors tha t are of prognostic significance and predictive value in tumor recurre nce, the authors studied 278 patients (243 men, 35 women) who had hepa tectomy for hepatocellular carcinoma. Disease free and actuarial survi val were correlated with 20 pathologic parameters of the resected spec imens using multivariate analysis. Results, The median follow-up perio d was 23.6 months. The overall disease free survival rates at 1, 3 and 5 years were 42%, 23%, and 17%, respectively, and the overall actuari al survival rates for the corresponding time periods were 70%, 39%, an d 28%, respectively. The results indicated that tumor encapsulation (P = 0.004) and heavy intratumor inflammatory infiltrates (P = 0.003) we re independent favorable factors related to tumor recurrence. Negative resection margins (P = 0.001) and heavy intratumor inflammatory infil trates (P = 0.003) were independent favorable factors correlated with survival. Conclusions. From this analysis, it was determined that deta iled histologic examination of resected specimens of hepatocellular ca rcinoma is important in assessing long term prognosis and stratificati on of patients for treatment.