title: Prognostic factors of solitary large hepatocellular carcinoma: the importance of differentiation grade.
abstract: OBJECTIVE
  Solitary large hepatocellular carcinoma (SL-HCC), a novel subtype with relative good prognosis, has recently been defined. However, the concept has not been validated. Besides, prognostic factors of SL-HCC remain unknown. The present study is designed to address the issues.
  
  
  METHODS
  Clinicopathological variables and survival of consecutive 85 patients with SL-HCC after curative resection are compared with those of 48 patients with small HCC (SHCC). The prognosticators of SL-HCC are also evaluated.
  
  
  RESULTS
  Disease-free survival of SL-HCC is similar with that of SHCC, whereas significant poorer overall survival is observed in SL-HCC than that in SHCC, accompanied by more frequent vascular invasion, later TNM stage and potentially higher Edmondson-Steiner grade. Vascular invasion, Edmondson-Steiner grade, TNM stage and preoperative AFP level impact overall and/or disease-free survival of SL-HCC, but only Edmondson-Steiner grade is independent. Additionally, differences in both overall and disease-free survival between SL-HCC with Edmondson-Steiner grade I-II and SHCC are all not significant.
  
  
  CONCLUSIONS
  Factors predictive for prognosis of SL-HCC are all tumor-related. The involvement of differentiation grade might be helpful for further distinguishing a particularly good outcome in SL-HCC.
authors.affiliation: Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. lizhou02@hotmail.com
authors.forename: L
authors.initials: L
authors.lastname: Zhou
authors.forename: J-A
authors.initials: JA
authors.lastname: Rui
authors.forename: S-B
authors.initials: SB
authors.lastname: Wang
authors.forename: S-G
authors.initials: SG
authors.lastname: Chen
authors.forename: Q
authors.initials: Q
authors.lastname: Qu
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000601:surgery; D002454:Cell Differentiation; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis