COMPARISON OF TUMOR PATHOLOGY WITH DURATION OF SURVIVAL OF NORTH-AMERICAN PATIENTS WITH HEPATOCELLULAR-CARCINOMA

Background. Several of the large studies addressing prognosis and surv ival from hepatocellular carcinoma (HCC) have been from Europe and Asi a, but only a few have emanated from North America, Survival statistic s from other parts of the world may not be applicable to the North Ame rican population because of etiologic, demographic, cultural, lifestyl e, and intangible differences. The current study investigated the surv ival experience and histologic correlates of North American patients w ith HCC and compared findings with similar studies from North America and other parts of the world. Methods. One thousand sixty-three patien ts examined during a Ii-year period, met inclusion criteria for this s tudy, Each patient was placed in one of three categories based on the duration of survival from date of diagnosis of HCC, Each tumor was exa mined histologically and classified according to World Health Organiza tion criteria, Patient's sex and age at diagnosis were obtained from c ase records. Survival analyses and comparisons were performed using ap propriate methods. Variables were tested for association using chi-squ are tests and randomization tests as appropriate. Results. Age, sex, t umor growth pattern, Edmondson and Steiner's nuclear grades, mitotic i ndex, and presence or absence of tumor giant cells or portal venous in vasion, were found to have statistically significant P < 0.05) relatio nships with the duration of patient survival, Significantly better sur vival was found to be associated with female sex, low nuclear grade, l ow mitotic index, age at diagnosis younger than 50 years, absence of g iant cells, and absence of portal venous invasion. Conclusions. Certai n histopathologic features of HCC may be useful for predicting patient survival and, thus, for empiric prognostication of these patients.