Characteristics of multicentric hepatocellular carcinomas: Comparison withintrahepatic metastasis

Characteristics of multicentric hepatocellular carcinomas (HCCs) remain obs cure. We therefore aimed to clarify them and compare them with HCC with int rahepatic metastases. A series of 118 patients who had definite hepatitis C viral status and multinodular HCC were divided into two groups: a multicen tric occurrence (MO) group (n = 38), with multicentric HCCs; and an intrahe patic metastasis (IM) group (n = 80), with HCC having intrahepatic metastas es. Clinicopathologic variables, including the patient's survival and disea se-free survival rates, were compared between the MO and IM groups. Univari ate analysis revealed the presence of esophageal varices, the presence of h epatitis C virus infection, a platelet count of less than 10 x 10(4)/mul, h epaplastin test, gamma -globulin, the histologically active hepatitis, tumo r size, des-gamma -carboxy prothrombin > 0.1 AU/ml, positive portal vein in vasion, and histologic grade as discriminating factors. The MO score to dif ferentiate multicentric HCCs from intrahepatic metastatic HCCs was determin ed using the following four independent factors selected by a stepwise regr ession analysis: the presence of hepatitis C virus infection, a platelet co unt of less than 10 x 10(4)/mul, tumor size, and histologic grade. The sens itivity and specificity of the MO scores using those factors were 84% and 7 0%, respectively, when the cutoff value was 0.4. The disease-free survival rate in the MO group was similar to that in the IM group, whereas the survi val rate in the MO group was significantly better than that in the IM group . The multivariate analysis revealed the multicentric occurrence of HCC as one of the independent prognostic factors. Clinicopathologic factors differ entiating multicentric HCCs from intrahepatic metastatic HCCs were the pres ence of hepatitis C virus infection, a platelet count of less than 10 x 10( 4)/mul, small tumor size, and low histologic grade.