title: The clinicopathological impact of gross classification on solitary small hepatocellular carcinoma.
abstract: OBJECTIVE
  The aim of this retrospective study was to determine the effect of gross classification on the outcome of hepatic resection for small solitary hepatocellular carcinoma (HCC).
  
  
  METHODS
  This study consisted of 179 consecutive primary HCC patients who were not preoperatively diagnosed with vascular invasion or intrahepatic metastasis. The clinicopathological impact of gross classification was compared. Patients were classified into four groups, vaguely nodular (VN) type, single nodular (SN) type, single nodular type with extranodular growth (SNEG), and confluent multinodular (CMN) type, according to the gross classification of resected specimens.
  
  
  RESULTS
  The SNEG and CMN types showed a significantly higher rate of MVI and intrahepatic metastasis than VN and SN type. Multivariate analysis showed SNEG and CMN type is independent predictor of MVI. The survival rates and the disease free survival rates of four groups were equal after curative hepatectomy.
  
  
  CONCLUSIONS
  This study demonstrated that the gross classifications were correlated significantly with the prevalence of MVI or intrahepatic metastasis, and that aggressive tumor spread in the SNEG type and in the CMN type was observed even in patients with small solitary HCC.
authors.forename: Eiji
authors.initials: E
authors.lastname: Tsujita
authors.forename: Yo-ichi
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Kazuki
authors.initials: K
authors.lastname: Takeishi
authors.forename: Ayumi
authors.initials: A
authors.lastname: Matsuyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Maeda
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Tsutsui
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Matsuda
authors.forename: Teruyoshi
authors.initials: T
authors.lastname: Ishida
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000145:classification / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000145:classification / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016015:Logistic Models; D008297:Male; D055806:Microvessels / Q000473:pathology*; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden