title: Morphological and histological features of resected hepatocellular carcinoma in cirrhotic patients in the West.
abstract: The pathological findings of 26 consecutive resections for hepatocellular carcinomas developing in cirrhotic patients were analyzed morphologically with a special interest in the presence of a capsule, vascular extension and satellite nodules. Tumor sizes varied from 2 to 11 cm. There were 20 expanding (76.9%) and six infiltrating tumors. Infiltrating tumors were significantly larger than expanding tumors (p less than 0.01). Histologically, the most common subgroups were the trabeculated pattern (65.4%) and the Edmonson-Steiner Type II (53.9%). Of the 20 expanding tumors, only six had direct spread in the liver parenchyma adjacent to the tumor (p less than 0.02). There was a significant relationship between the presence of a tumor extension in the distal portal branches and the presence of satellite nodules around the tumor (p less than 0.01). Survival at 6 months was significantly lower in patients with infiltrating (16.7%) than in those with expanding tumors (75%), (p less than 0.05). The present results indicate that pathological features of hepatocellular carcinomas in cirrhotic patients in Western countries are similar to those encountered in the East: (a) tumors are frequently encapsulated; (b) the propensity for the tumor to spread is closely related to the presence of a tumor capsule. This study suggests that a thorough preoperative search for the capsule should be made whenever resection of a hepatocellular carcinoma in a cirrhotic patient is contemplated.
authors.affiliation: Groupe de Recherche sur la Chirurgie du Foie et de l'Hypertension Portale, Université Paris-Sud, France.
authors.forename: F
authors.initials: F
authors.lastname: Kemeny
authors.forename: J
authors.initials: J
authors.lastname: Vadrot
authors.forename: A
authors.initials: A
authors.lastname: Wu
authors.forename: C
authors.initials: C
authors.lastname: Smadja
authors.forename: J L
authors.initials: JL
authors.lastname: Meakins
authors.forename: D
authors.initials: D
authors.lastname: Franco
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications*; D008113:Liver Neoplasms / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged