Predictive value of gross classification of hepatocellular carcinoma on recurrence and survival after hepatectomy.
OBJECTIVE
A new gross classification of hepatocellular carcinoma in which Eggel's nodular type is subclassified into type 1 (single nodular type), type 2 (single nodular type with extranodular growth), and type 3 (contiguous multinodular type) has been widely used in Japan. The aim of the study was to determine whether this classification is correlated with patient outcome.


METHODS
Sixty-five resected hepatocellular carcinoma nodules (< or = 5 cm) were classified using this new classification.


RESULTS
The 65 tumors were classified into 30 type 1 (46%), 20 type 2 (31%), and 15 type 3 (23%) hepatocellular carcinomas. The rate of microscopic vascular invasion significantly increased from type 1 to type 2, and to type 3 tumors (p=0.03). Kaplan-Meier estimates showed that type 1 was significantly associated with lower recurrence rate (type 1 vs. type 2, p=0.01; type 1 vs. type 3, p=0.004; log-rank test), and higher disease-specific survival (type 1 vs. type 2, p=0.02; type 1 vs. type 3, p=0.002). Cox's proportional-hazards model demonstrated that type 1 was an independent factor for low risk of recurrence (p=0.002) and low risk of disease-specific death (p=0.02).


CONCLUSIONS
The gross classification of hepatocellular carcinoma is of clinical value in predicting patient outcome.
Hui
A M
AM
Department of Surgery, Graduate School of Medicine, University of Tokyo, Japan.
Takayama
T
T
Sano
K
K
Kubota
K
K
Akahane
M
M
Ohtomo
K
K
Makuuchi
M
M
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000145:classification* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000145:classification* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011237:Predictive Value of Tests; D016019:Survival Analysis