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Article: Tumor size predicts vascular invasion and histologic grade: Implications for selection of surgical treatment for hepatocellular carcinoma

TitleTumor size predicts vascular invasion and histologic grade: Implications for selection of surgical treatment for hepatocellular carcinoma
Authors
Issue Date2005
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021
Citation
Liver Transplantation, 2005, v. 11 n. 9, p. 1086-1092 How to Cite?
AbstractVascular invasion and high histologic grade predict poor outcome after surgical resection or liver transplantation for hepatocellular carcinoma (HCC). Despite the known association between tumor size and vascular invasion, a proportion of patients with large tumors can be treated surgically with excellent outcomes. Clarification of the association between tumor size, histologic grade, and vascular invasion has implications for patient selection for resection and transplantation. The objective of this study was to examine the relationship between HCC tumor size and microscopic (occult) vascular invasion and histologic grade in a multicenter international database of 1,073 patients who underwent resection of HCC. The incidence of microscopic vascular invasion increased with tumor size (≤3 cm, 25%; 3.1-5 cm, 40%; 5.1-6.5 cm, 55%; >6.5 cm, 63%) (P < 0.005). Both size and number of tumors were important factors predicting vascular invasion. Among all patients with tumors 5.1 to 6.5 cm, microscopic vascular invasion was present in 55% compared with 31% for all patients with tumors 5 cm or smaller (P < 0.001). Among patients with solitary tumors only, microscopic vascular invasion was significantly more common in tumors measuring 5.1 to 6.5 cm (41%) compared with 27% of tumors 5 cm or smaller (P < 0.003). Tumor size also predicted histologic grade: 36% of tumors 5 cm or smaller were high grade, compared with 54% of lesions 5.1 to 6.5 cm. (P = 0.01). High histologic grade, an alpha-fetoprotein level of at least 1000 ng/mL, and multiple tumor nodules each predicted occult vascular invasion in tumors larger than 5 cm. The high incidence of occult vascular invasion and advanced histologic grade in HCC tumors larger than 5 cm, as well as biologic predictors of poor prognosis, should be considered before criteria for transplantation are expanded to include these patients. Copyright © 2005 by the American Association for the Study of Liver Diseases.
Persistent Identifierhttp://hdl.handle.net/10722/88765
ISSN
2015 Impact Factor: 3.951
2015 SCImago Journal Rankings: 1.763
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorPawlik, TMen_HK
dc.contributor.authorDelman, KAen_HK
dc.contributor.authorVauthey, JNen_HK
dc.contributor.authorNagorney, DMen_HK
dc.contributor.authorNg, IOLen_HK
dc.contributor.authorIkai, Ien_HK
dc.contributor.authorYamaoka, Yen_HK
dc.contributor.authorBelghitti, Jen_HK
dc.contributor.authorLauwers, GYen_HK
dc.contributor.authorPoon, RTen_HK
dc.contributor.authorAbdalla, EKen_HK
dc.date.accessioned2010-09-06T09:47:41Z-
dc.date.available2010-09-06T09:47:41Z-
dc.date.issued2005en_HK
dc.identifier.citationLiver Transplantation, 2005, v. 11 n. 9, p. 1086-1092en_HK
dc.identifier.issn1527-6465en_HK
dc.identifier.urihttp://hdl.handle.net/10722/88765-
dc.description.abstractVascular invasion and high histologic grade predict poor outcome after surgical resection or liver transplantation for hepatocellular carcinoma (HCC). Despite the known association between tumor size and vascular invasion, a proportion of patients with large tumors can be treated surgically with excellent outcomes. Clarification of the association between tumor size, histologic grade, and vascular invasion has implications for patient selection for resection and transplantation. The objective of this study was to examine the relationship between HCC tumor size and microscopic (occult) vascular invasion and histologic grade in a multicenter international database of 1,073 patients who underwent resection of HCC. The incidence of microscopic vascular invasion increased with tumor size (≤3 cm, 25%; 3.1-5 cm, 40%; 5.1-6.5 cm, 55%; >6.5 cm, 63%) (P < 0.005). Both size and number of tumors were important factors predicting vascular invasion. Among all patients with tumors 5.1 to 6.5 cm, microscopic vascular invasion was present in 55% compared with 31% for all patients with tumors 5 cm or smaller (P < 0.001). Among patients with solitary tumors only, microscopic vascular invasion was significantly more common in tumors measuring 5.1 to 6.5 cm (41%) compared with 27% of tumors 5 cm or smaller (P < 0.003). Tumor size also predicted histologic grade: 36% of tumors 5 cm or smaller were high grade, compared with 54% of lesions 5.1 to 6.5 cm. (P = 0.01). High histologic grade, an alpha-fetoprotein level of at least 1000 ng/mL, and multiple tumor nodules each predicted occult vascular invasion in tumors larger than 5 cm. The high incidence of occult vascular invasion and advanced histologic grade in HCC tumors larger than 5 cm, as well as biologic predictors of poor prognosis, should be considered before criteria for transplantation are expanded to include these patients. Copyright © 2005 by the American Association for the Study of Liver Diseases.en_HK
dc.languageengen_HK
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021en_HK
dc.relation.ispartofLiver Transplantationen_HK
dc.rightsLiver Transplantation. Copyright © John Wiley & Sons, Inc.en_HK
dc.subject.meshAdolescenten_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshCarcinoma, Hepatocellular - pathology - secondary - surgeryen_HK
dc.subject.meshChilden_HK
dc.subject.meshChild, Preschoolen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHepatectomyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLiver Neoplasms - pathology - surgeryen_HK
dc.subject.meshLiver Transplantationen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshNeoplasm Invasivenessen_HK
dc.subject.meshNeoplasm Stagingen_HK
dc.subject.meshPatient Selectionen_HK
dc.subject.meshVascular Neoplasms - secondary - surgeryen_HK
dc.titleTumor size predicts vascular invasion and histologic grade: Implications for selection of surgical treatment for hepatocellular carcinomaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1527-6465&volume=11&issue=9&spage=1086&epage=92&date=2005&atitle=Tumor+size+predicts+vascular+invasion+and+histologic+grade:+Implications+for+selection+of+surgical+treatment+for+hepatocellular+carcinomaen_HK
dc.identifier.emailNg, IOL: iolng@hkucc.hku.hken_HK
dc.identifier.emailPoon, RT: poontp@hkucc.hku.hken_HK
dc.identifier.authorityNg, IOL=rp00335en_HK
dc.identifier.authorityPoon, RT=rp00446en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/lt.20472en_HK
dc.identifier.pmid16123959-
dc.identifier.scopuseid_2-s2.0-25144483939en_HK
dc.identifier.hkuros114068en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-25144483939&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume11en_HK
dc.identifier.issue9en_HK
dc.identifier.spage1086en_HK
dc.identifier.epage1092en_HK
dc.identifier.isiWOS:000231582200011-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridPawlik, TM=7006249269en_HK
dc.identifier.scopusauthoridDelman, KA=6602139878en_HK
dc.identifier.scopusauthoridVauthey, JN=35270590000en_HK
dc.identifier.scopusauthoridNagorney, DM=35400419300en_HK
dc.identifier.scopusauthoridNg, IOL=7102753722en_HK
dc.identifier.scopusauthoridIkai, I=7006764463en_HK
dc.identifier.scopusauthoridYamaoka, Y=7201994050en_HK
dc.identifier.scopusauthoridBelghitti, J=24377516100en_HK
dc.identifier.scopusauthoridLauwers, GY=35391239300en_HK
dc.identifier.scopusauthoridPoon, RT=7103097223en_HK
dc.identifier.scopusauthoridAbdalla, EK=7006112354en_HK

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