Mitotic index is the best predictive factor for survival of patients with resected hepatocellular carcinoma

Background: In patients with hepatocellular carcinoma (HCC), tumor recurren ce is not infrequent after resection. It is presumed that characteristics o f the tumor such as cellular malignancy might influence the prognosis of th e patients in association with tumor stage and radicality of the procedure. Methods: Univariate and multivariate analyses were used to retrospectively determine the clinicopathologic factors potentially related to survival in 40 patients who underwent hepatectomy for HCC. Results: In univariate anal ysis, tumor stage I or II, mitotic index of 4 or less/10 random high-power fields, solitary tumor, and curative resection were significantly correlate d with better survival. In multivariate analysis, the mitotic index and sur gical curability were independently significant variables influencing survi val of patients, and the mitotic index was the best predictive factor. A hi ghly significant correlation was found between the mitotic index and Ki-67 labeling index. Compared to tumors with a mitotic index of 4 or less, those with a mitotic index of 5 or more had a higher association with multiple t umors and advanced tumor stage, which preclude curative resection. Conclusi on: Analysis of the mitotic index is quite simple, and the mitotic index co uld be a useful factor for predicting the long-term survival of patients wi th HCC following hepatic resection. Copyright (C) 2000 S. Karger AG. Basel.