title: The comparison of surgical patients with primary hepatic squamous cell carcinoma or adenosquamous carcinoma and surgical patients with hepatocellular carcinoma.
abstract: BACKGROUND
  There are still several controversies and ambiguities in the aspects of primary hepatic squamous cell carcinoma and primary hepatic adenosquamous carcinoma. To further clarify the specific features of these two infrequent diseases and provide beneficial propose for clinical decision, we did this retrospective study.
  
  
  METHODS
  We reviewed the clinical features and outcomes of three primary hepatic squamous cell carcinoma (SCC) patients and six primary hepatic adenosquamous carcinoma (ASC) patients from January 1998 to December 2011 in Eastern Hepatobiliary Surgery Hospital in China. Meanwhile, 40 hepatocellular carcinoma (HCC) patients and 26 metastatic hepatic SCC or ASC patients who were hospitalized in the same period were also reviewed to make a comparison. In order to find out the definite survival information of SCC and ASC patients, 30 previous studies containing 37 primary hepatic SCC (16) and ASC (21) patients were reviewed, and their information of survival was analyzed together with the included patients in our hospital.
  
  
  RESULTS
  Serum tumor markers showed significant differences between primary hepatic SCC/ASC and HCC patients, especially for serum alpha fetal protein (AFP) level and carbohydrate antigen 19-9 (CA 19-9). On the pathologic performance, primary SCC/ASC tumor was rarely accompanied with tumor capsule. They presented peripheral hepatic lymph node metastasis more likely and showed low proportion of microvascular invasion. The median survival time of primary hepatic SCC/ASC patients after liver resection (LR) was 15 months. And the 1-, 3-, 5-year survival rates after LR were 60%, 24%, and 12%, respectively. Significant difference was not discovered when SCC and ASC patients were compared with HCC patients (P = 0.294). The median survival time after LR for primary SCC and ASC patients was respectively 23 months and 13 months.
  
  
  CONCLUSIONS
  The comprehensive application of some clinical characteristics, histopathologic features, and imaging findings may be useful for us in making definite diagnoses for primary hepatic SCC and ASC patients preoperatively. And the treatment of liver resection was effective for those patients who met the selection criteria for liver resection.
authors.affiliation: Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Hospital, the Second Military Medical University, 255 Changhai Road, Shanghai, 200438, China. hunanxiefeng@yahoo.com.cn.
authors.forename: Long
authors.initials: L
authors.lastname: Yan
authors.affiliation: Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Hospital, the Second Military Medical University, 255 Changhai Road, Shanghai, 200438, China. hunanxiefeng@aliyun.com.
authors.forename: Feng
authors.initials: F
authors.lastname: Xie
authors.affiliation: Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Hospital, the Second Military Medical University, 255 Changhai Road, Shanghai, 200438, China. tuoye@sinochem.com.
authors.forename: Cheng
authors.initials: C
authors.lastname: Yang
authors.affiliation: Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Hospital, the Second Military Medical University, 255 Changhai Road, Shanghai, 200438, China. tyxyr_0407@163.com.
authors.forename: Lihan
authors.initials: L
authors.lastname: Yu
authors.affiliation: Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Hospital, the Second Military Medical University, 255 Changhai Road, Shanghai, 200438, China. 31796891@qq.com.
authors.forename: Tao
authors.initials: T
authors.lastname: Zheng
authors.affiliation: Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Hospital, the Second Military Medical University, 255 Changhai Road, Shanghai, 200438, China. 2417067217@qq.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Fu
authors.affiliation: Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Hospital, the Second Military Medical University, 255 Changhai Road, Shanghai, 200438, China. 13386272885@189.cn.
authors.forename: Jiamei
authors.initials: J
authors.lastname: Yang
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018196:Carcinoma, Adenosquamous / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate