Clinicopathological Features and Metastatic Pattern of Hepatocellular Carcinoma: An Autopsy Study of 398 Patients.
OBJECTIVE
Analysis of a large local autopsy collective to gather epidemiological and histopathological data on hepatocellular carcinoma (HCC).


METHODS
We examined a large dataset of 44,104 autopsies performed at the Institute of Pathology, Basel, Switzerland, including 2 autopsy collectives (1969-1983 and 1988-2012) to gather current data on HCC in the advanced stage. A total of 398 HCC were diagnosed, accounting for around 1% of all autopsies.


RESULTS
As expected, most patients developing HCC had advanced stages of liver fibrosis or cirrhosis (F3/F4). However, in the more recent autopsy collective (1988-2012), our data also show an increase of HCC arising in livers without or with only mild to moderate fibrosis (F0-F2). Extrahepatic metastasis was found in 156 of 398 HCC (39.1%), with lung metastasis (74.5%) being the most common, followed by the bones (24.8%) and adrenal glands (19.1%).


CONCLUSIONS
Our data therefore seem to suggest that, in the last 2 decades, despite the introduction of new therapeutic modalities for HCC, no significant changes have been observed regarding the metastatic pattern of advanced HCC.
Department of Pathology, University Hospital Basel, Basel, Switzerland.
Manuel
M
Schlageter
Luca
L
Quagliata
Matthias
M
Matter
Valeria
V
Perrina
Luigi
L
Tornillo
Luigi
L
Terracciano
D000310:Adrenal Gland Neoplasms / Q000556:secondary; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D001859:Bone Neoplasms / Q000556:secondary; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000453:epidemiology / Q000556:secondary*; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications* / Q000453:epidemiology; D008113:Liver Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D008175:Lung Neoplasms / Q000150:complications / Q000453:epidemiology / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D013557:Switzerland / Q000453:epidemiology