Skip to main content
Erschienen in: Hepatology International 2/2021

05.02.2021 | Original Article

Clinical manifestations and outcomes of patients with scirrhous hepatocellular carcinoma

verfasst von: Shang-Chin Huang, Sih-Han Liao, Tung-Hung Su, Yung-Ming Jeng, Jia-Horng Kao

Erschienen in: Hepatology International | Ausgabe 2/2021

Einloggen, um Zugang zu erhalten

Abstract

Background

The scirrhous hepatocellular carcinoma (HCC) is a rare subtype characterized by prominent fibrous stroma separating nests of tumor cells histologically. The clinical characteristics of scirrhous HCC have not been clearly elucidated due to limited literatures. We aimed to investigate the clinical manifestations and outcomes of patients with scirrhous HCC.

Methods

A total of 4012 patients with histologically proven HCC from the Cancer Registry Database (2004–2016) of the National Taiwan University Hospital (NTUH) were enrolled; whereas, 30 patients with scirrhous HCC were identified from the pathology database of NTUH. We matched 120 patients with non-scirrhous HCC through propensity score according to sex, age, Barcelona Clinic Liver Cancer stage and initial treatment modality for comparison.

Results

No significant difference in baseline characteristics and presentations was observed between the patients with scirrhous and non-scirrhous HCC except baseline alpha-fetoprotein level. The overall survival was comparable in these two groups. For the patients undergoing curative therapy, the risk of recurrence in the patients with scirrhous HCC was significantly higher within 24 months after curative therapy (hazard ratio [HR], 2.88, 95% confidence interval [CI], 1.43–5.80, p value, 0.003) as compared with those with non-scirrhous HCC. The overall recurrence rate was comparable in these two groups.

Conclusions

Using propensity score matching, the risk of recurrence in the patients with scirrhous HCC was significantly higher in the first 2 years after curative therapy as compared to those with non-scirrhous HCC. An individualized post-curative treatment monitoring strategy should be considered for the patients with scirrhous HCC.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Akinyemiju T, Abera S, Ahmed M, Alam N, Alemayohu MA, Allen C, et al. The burden of primary liver cancer and underlying etiologies from 1990 to 2015 at the global, regional, and national level: results from the global burden of disease study 2015. JAMA Oncol. 2017;3:1683–91.CrossRef Akinyemiju T, Abera S, Ahmed M, Alam N, Alemayohu MA, Allen C, et al. The burden of primary liver cancer and underlying etiologies from 1990 to 2015 at the global, regional, and national level: results from the global burden of disease study 2015. JAMA Oncol. 2017;3:1683–91.CrossRef
2.
Zurück zum Zitat Liao SH, Su TH, Jeng YM, Liang PC, Chen DS, Chen CH, et al. Clinical manifestations and outcomes of patients with sarcomatoid hepatocellular carcinoma. Hepatology. 2019;69:209–21.CrossRef Liao SH, Su TH, Jeng YM, Liang PC, Chen DS, Chen CH, et al. Clinical manifestations and outcomes of patients with sarcomatoid hepatocellular carcinoma. Hepatology. 2019;69:209–21.CrossRef
3.
Zurück zum Zitat Bosman FT, Carneiro F, Hruban RH, Theise ND. WHO classification of tumours of the digestive system. Geneva: World Health Organization; 2010. Bosman FT, Carneiro F, Hruban RH, Theise ND. WHO classification of tumours of the digestive system. Geneva: World Health Organization; 2010.
4.
Zurück zum Zitat Nagtegaal ID, Odze RD, Klimstra D, Paradis V, Rugge M, Schirmacher P, et al. The 2019 WHO classification of tumours of the digestive system. Histopathology. 2020;76:182–8.CrossRef Nagtegaal ID, Odze RD, Klimstra D, Paradis V, Rugge M, Schirmacher P, et al. The 2019 WHO classification of tumours of the digestive system. Histopathology. 2020;76:182–8.CrossRef
5.
Zurück zum Zitat Shafizadeh N, Kakar S. Hepatocellular carcinoma: histologic subtypes. Surg Pathol Clin. 2013;6:367–84.CrossRef Shafizadeh N, Kakar S. Hepatocellular carcinoma: histologic subtypes. Surg Pathol Clin. 2013;6:367–84.CrossRef
6.
Zurück zum Zitat Kurogi M, Nakashima O, Miyaaki H, Fujimoto M, Kojiro M. Clinicopathological study of scirrhous hepatocellular carcinoma. J Gastroenterol Hepatol. 2006;21:1470–7.PubMed Kurogi M, Nakashima O, Miyaaki H, Fujimoto M, Kojiro M. Clinicopathological study of scirrhous hepatocellular carcinoma. J Gastroenterol Hepatol. 2006;21:1470–7.PubMed
7.
Zurück zum Zitat Kim SH, Lim HK, Lee WJ, Choi D, Park CK. Scirrhous hepatocellular carcinoma: comparison with usual hepatocellular carcinoma based on CT-pathologic features and long-term results after curative resection. Eur J Radiol. 2009;69:123–30.CrossRef Kim SH, Lim HK, Lee WJ, Choi D, Park CK. Scirrhous hepatocellular carcinoma: comparison with usual hepatocellular carcinoma based on CT-pathologic features and long-term results after curative resection. Eur J Radiol. 2009;69:123–30.CrossRef
8.
Zurück zum Zitat Lee JH, Choi MS, Gwak GY, Lee JH, Koh KC, Paik SW, et al. Clinicopathologic characteristics and long-term prognosis of scirrhous hepatocellular carcinoma. Dig Dis Sci. 2012;57:1698–707.CrossRef Lee JH, Choi MS, Gwak GY, Lee JH, Koh KC, Paik SW, et al. Clinicopathologic characteristics and long-term prognosis of scirrhous hepatocellular carcinoma. Dig Dis Sci. 2012;57:1698–707.CrossRef
10.
Zurück zum Zitat Sugiki T, Yamamoto M, Taka K, Nakano M. Specific characteristics of scirrhous hepatocellular carcinoma. Hepatogastroenterology. 2009;56:1086–9.PubMed Sugiki T, Yamamoto M, Taka K, Nakano M. Specific characteristics of scirrhous hepatocellular carcinoma. Hepatogastroenterology. 2009;56:1086–9.PubMed
11.
Zurück zum Zitat Bergstralh E, Kosanke J. Computerized matching of cases to controls. Technical Report 56. Rochester: Mayo Foundation; 1995. Bergstralh E, Kosanke J. Computerized matching of cases to controls. Technical Report 56. Rochester: Mayo Foundation; 1995.
12.
Zurück zum Zitat Tseng TC, Liu CJ, Su TH, Yang WT, Chen CL, Yang HC, et al. Fibrosis-4 index helps identify HBV carriers with the lowest risk of hepatocellular carcinoma. Am J Gastroenterol. 2017;112:1564–74.CrossRef Tseng TC, Liu CJ, Su TH, Yang WT, Chen CL, Yang HC, et al. Fibrosis-4 index helps identify HBV carriers with the lowest risk of hepatocellular carcinoma. Am J Gastroenterol. 2017;112:1564–74.CrossRef
13.
Zurück zum Zitat Johnson PJ, Berhane S, Kagebayashi C, Satomura S, Teng M, Reeves HL, et al. Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach-the ALBI grade. J Clin Oncol. 2015;33:550–8.CrossRef Johnson PJ, Berhane S, Kagebayashi C, Satomura S, Teng M, Reeves HL, et al. Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach-the ALBI grade. J Clin Oncol. 2015;33:550–8.CrossRef
14.
Zurück zum Zitat Management consensus guideline for hepatocellular carcinoma. 2016 updated by the Taiwan Liver Cancer Association and the Gastroenterological Society of Taiwan. J Formos Med Assoc. 2018;117:381–403.CrossRef Management consensus guideline for hepatocellular carcinoma. 2016 updated by the Taiwan Liver Cancer Association and the Gastroenterological Society of Taiwan. J Formos Med Assoc. 2018;117:381–403.CrossRef
15.
Zurück zum Zitat Omata M, Cheng AL, Kokudo N, Kudo M, Lee JM, Jia J, et al. Asia-Pacific clinical practice guidelines on the management of hepatocellular carcinoma: a 2017 update. Hepatol Int. 2017;11:317–70.CrossRef Omata M, Cheng AL, Kokudo N, Kudo M, Lee JM, Jia J, et al. Asia-Pacific clinical practice guidelines on the management of hepatocellular carcinoma: a 2017 update. Hepatol Int. 2017;11:317–70.CrossRef
16.
Zurück zum Zitat Marrero JA, Kulik LM, Sirlin CB, Zhu AX, Finn RS, Abecassis MM, et al. Diagnosis, staging, and management of hepatocellular carcinoma: 2018 practice guidance by the American association for the study of liver diseases. Hepatology. 2018;68:723–50.CrossRef Marrero JA, Kulik LM, Sirlin CB, Zhu AX, Finn RS, Abecassis MM, et al. Diagnosis, staging, and management of hepatocellular carcinoma: 2018 practice guidance by the American association for the study of liver diseases. Hepatology. 2018;68:723–50.CrossRef
17.
Zurück zum Zitat EASL. EASL clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2018;69:182–236.CrossRef EASL. EASL clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2018;69:182–236.CrossRef
18.
Zurück zum Zitat Hatano M, Ojima H, Masugi Y, Tsujikawa H, Hiraoka N, Kanai Y, et al. Steatotic and nonsteatotic scirrhous hepatocellular carcinomas reveal distinct clinicopathological features. Hum Pathol. 2019;86:222–32.CrossRef Hatano M, Ojima H, Masugi Y, Tsujikawa H, Hiraoka N, Kanai Y, et al. Steatotic and nonsteatotic scirrhous hepatocellular carcinomas reveal distinct clinicopathological features. Hum Pathol. 2019;86:222–32.CrossRef
19.
Zurück zum Zitat Imamura H, Matsuyama Y, Tanaka E, Ohkubo T, Hasegawa K, Miyagawa S, et al. Risk factors contributing to early and late phase intrahepatic recurrence of hepatocellular carcinoma after hepatectomy. J Hepatol. 2003;38:200–7.CrossRef Imamura H, Matsuyama Y, Tanaka E, Ohkubo T, Hasegawa K, Miyagawa S, et al. Risk factors contributing to early and late phase intrahepatic recurrence of hepatocellular carcinoma after hepatectomy. J Hepatol. 2003;38:200–7.CrossRef
21.
Zurück zum Zitat Cheng Z, Yang P, Qu S, Zhou J, Yang J, Yang X, et al. Risk factors and management for early and late intrahepatic recurrence of solitary hepatocellular carcinoma after curative resection. HPB (Oxford). 2015;17:422–7.CrossRef Cheng Z, Yang P, Qu S, Zhou J, Yang J, Yang X, et al. Risk factors and management for early and late intrahepatic recurrence of solitary hepatocellular carcinoma after curative resection. HPB (Oxford). 2015;17:422–7.CrossRef
22.
Zurück zum Zitat Xu XF, Xing H, Han J, Li ZL, Lau WY, Zhou YH, et al. Risk factors, patterns, and outcomes of late recurrence after liver resection for hepatocellular carcinoma: a multicenter study from China. JAMA Surg. 2019;154:209–17.CrossRef Xu XF, Xing H, Han J, Li ZL, Lau WY, Zhou YH, et al. Risk factors, patterns, and outcomes of late recurrence after liver resection for hepatocellular carcinoma: a multicenter study from China. JAMA Surg. 2019;154:209–17.CrossRef
23.
Zurück zum Zitat Ding X, He M, Chan AWH, Song QX, Sze SC, Chen H, et al. Genomic and epigenomic features of primary and recurrent hepatocellular carcinomas. Gastroenterology. 2019;157(1630–1645):e1636. Ding X, He M, Chan AWH, Song QX, Sze SC, Chen H, et al. Genomic and epigenomic features of primary and recurrent hepatocellular carcinomas. Gastroenterology. 2019;157(1630–1645):e1636.
24.
Zurück zum Zitat Seok JY, Na DC, Woo HG, Roncalli M, Kwon SM, Yoo JE, et al. A fibrous stromal component in hepatocellular carcinoma reveals a cholangiocarcinoma-like gene expression trait and epithelial-mesenchymal transition. Hepatology. 2012;55:1776–86.CrossRef Seok JY, Na DC, Woo HG, Roncalli M, Kwon SM, Yoo JE, et al. A fibrous stromal component in hepatocellular carcinoma reveals a cholangiocarcinoma-like gene expression trait and epithelial-mesenchymal transition. Hepatology. 2012;55:1776–86.CrossRef
25.
Zurück zum Zitat Calderaro J, Couchy G, Imbeaud S, Amaddeo G, Letouzé E, Blanc JF, et al. Histological subtypes of hepatocellular carcinoma are related to gene mutations and molecular tumour classification. J Hepatol. 2017;67:727–38.CrossRef Calderaro J, Couchy G, Imbeaud S, Amaddeo G, Letouzé E, Blanc JF, et al. Histological subtypes of hepatocellular carcinoma are related to gene mutations and molecular tumour classification. J Hepatol. 2017;67:727–38.CrossRef
26.
Zurück zum Zitat Krings G, Ramachandran R, Jain D, Wu TT, Yeh MM, Torbenson M, et al. Immunohistochemical pitfalls and the importance of glypican 3 and arginase in the diagnosis of scirrhous hepatocellular carcinoma. Mod Pathol. 2013;26:782–91.CrossRef Krings G, Ramachandran R, Jain D, Wu TT, Yeh MM, Torbenson M, et al. Immunohistochemical pitfalls and the importance of glypican 3 and arginase in the diagnosis of scirrhous hepatocellular carcinoma. Mod Pathol. 2013;26:782–91.CrossRef
Metadaten
Titel
Clinical manifestations and outcomes of patients with scirrhous hepatocellular carcinoma
verfasst von
Shang-Chin Huang
Sih-Han Liao
Tung-Hung Su
Yung-Ming Jeng
Jia-Horng Kao
Publikationsdatum
05.02.2021
Verlag
Springer India
Erschienen in
Hepatology International / Ausgabe 2/2021
Print ISSN: 1936-0533
Elektronische ISSN: 1936-0541
DOI
https://doi.org/10.1007/s12072-021-10146-1

Weitere Artikel der Ausgabe 2/2021

Hepatology International 2/2021 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.