Detailed Abstract
[Liver Poster Presentation 4 - Liver (Liver Disease/Surgery)]
[LV PP 4-1] The Prognostic Impact Of Size According To Gross Type In Hepatocellular Carcinoma
Na Reum KIM1 , Gi Hong CHOI*1
1 Department Of Surgery, Division Of Hepato-biliary Pancreatic Surgery, REPUBLIC OF KOREA
Background : Tumor size is a significant prognostic factor for hepatocellular carcinoma (HCC). HCC is morpholocially subclassified into the vaguely nodular (VN), single nodular (SN), single nodular with extranodular growth (SNEG), confluent multinodular (CM), and infiltrative (INF) type. As the size increases for each gross type in HCC, the trend of tumor biologic features has not yet been revealed. This study aimed to investigate the prognostic impact of size according to gross type in HCC.
Methods : A total 1013 of 1045 patients who underwent curative resection for single HCC between 2007 and 2017, excluding 32 VN type HCC, were included in this study. The gross types were classified into 416 SN, 123 SNEG, 397 CM, and 77 INF type. The clinico-pathologic characteristics, overall survival (OS), and recurrence-free survival (RFS) were compared according to tumor size and gross type.
Results : The INF type demonstrated the worst OS and RFS compared to other types (5-year OS 66.5%, 5-year RFS 49.7%, P<0.001). However, SN, SNEG and CM type showed similar 5-year OS and RFS in both smaller than 3cm and larger than 3cm. According to tumor size, > 5cm in SN type (OS: P <0.001, RFS: P= 0.004) and >3cm in CM type (OS: P= 0.012, RFS: P <0.001) were associated with a decreased OS and RFS, and >3cm in SNEG type was poor prognostic factors for RFS (P= 0.011) on multivariate analysis. As the size increased (0-3, 3-5, 5-7, >7cm), microvascular invasion (MVI) was increased with the same trend in SN (P<0.001), SNEG (P= 0.004), and CM type (P<0.001), however, MVI in INF type was high from small size of tumor regardless of size. (70.8, 76.9, 77.8, 66.7%, P= 0.976).
Conclusions : The INF type HCC showed the worst prognosis regardless of tumor size. The tumor size affecting the prognosis was different for each gross type (SN 5cm, SNEG/CM 3cm). In addition, the tumor size expressing aggressive tumor biological behaviors such as MVI was different for each gross type. However, other than INF type, SN, SNEG, and CM type HCCs had comparable OS and RFS.
Methods : A total 1013 of 1045 patients who underwent curative resection for single HCC between 2007 and 2017, excluding 32 VN type HCC, were included in this study. The gross types were classified into 416 SN, 123 SNEG, 397 CM, and 77 INF type. The clinico-pathologic characteristics, overall survival (OS), and recurrence-free survival (RFS) were compared according to tumor size and gross type.
Results : The INF type demonstrated the worst OS and RFS compared to other types (5-year OS 66.5%, 5-year RFS 49.7%, P<0.001). However, SN, SNEG and CM type showed similar 5-year OS and RFS in both smaller than 3cm and larger than 3cm. According to tumor size, > 5cm in SN type (OS: P <0.001, RFS: P= 0.004) and >3cm in CM type (OS: P= 0.012, RFS: P <0.001) were associated with a decreased OS and RFS, and >3cm in SNEG type was poor prognostic factors for RFS (P= 0.011) on multivariate analysis. As the size increased (0-3, 3-5, 5-7, >7cm), microvascular invasion (MVI) was increased with the same trend in SN (P<0.001), SNEG (P= 0.004), and CM type (P<0.001), however, MVI in INF type was high from small size of tumor regardless of size. (70.8, 76.9, 77.8, 66.7%, P= 0.976).
Conclusions : The INF type HCC showed the worst prognosis regardless of tumor size. The tumor size affecting the prognosis was different for each gross type (SN 5cm, SNEG/CM 3cm). In addition, the tumor size expressing aggressive tumor biological behaviors such as MVI was different for each gross type. However, other than INF type, SN, SNEG, and CM type HCCs had comparable OS and RFS.
SESSION
Liver Poster Presentation 4
Poster Presentation 3/24/2023 2:50 PM - 3:50 PM