CIRRHOSIS, HEPATOCELLULAR-CARCINOMA, AND SURVIVAL - COMMENT

This study examined clinico-histopathologic differences between North American patients who developed hepatocellular carcinoma with and with out cirrhosis. Histologic slides and clinical records of cases were re viewed. Cases were classified according to defined histopathologic cri teria. Analyses were performed using appropriate tests. A total of 42. 6% of cases were noncirrhotic. The trabecular type of hepatocellular c arcinoma was the most common growth type pattern in both groups. Patie nts with cirrhosis were significantly older, had high grade tumors, an d local portal venous invasion significantly more often than patients without cirrhosis. Encapsulated tumors occurred in significantly more in patients without cirrhosis. Patients without cirrhosis survived lon ger than patients with cirrhosis (P < .0001) and had a better 5-year s urvival experience. On average, in patients with cirrhosis, serum aspa rtate transaminase and total serum bilirubin were significantly greate r, and serum albumin was significantly lower. In general, hepatocellul ar carcinoma in North American patients with cirrhosis tended to be le ss well differentiated than those found among patients without cirrhos is. The pathology, natural history, and prognosis of this tumor is sig nificantly influenced by the presence or absence of cirrhosis in the n onneoplastic liver, and the presence of cirrhosis portends a poorer pr ognosis.