BACKGROUND: A subset of patients with hepatocellular carcinoma (HCC) present with massive tumours. It is unknown why certain patients develop these massive tumours, and whether this presentation is specific to the underlying viral aetiology or patient demographics such as gender, race and age. METHODS: All patients with HCC at Bellevue Hospital Center, New York from 1998 to 2012 were identified and relevant demographic and clinical information was collected. Computed tomography/magnetic resonance imaging (CT/MRI) images were reviewed and the maximal tumour diameter on axial sections was recorded. Cirrhosis was defined histologically or by radiographical criteria. The two cohorts of massive and non-massive HCC were compared. RESULTS: A total of 361 patients with HCC were identified, of which 58 were categorized as having a massive HCC using a 13 cm size cut-off. Univariate and multivariate analysis demonstrated a significant association of massive HCC with age <40 years; hepatitis B or Asian ethnicity; and a lack of cirrhosis or platelet count >100. DISCUSSION: Massive HCC represents a tumour subtype that is associated with young, chronic hepatitis B carriers with non-cirrhotic livers. The clinical implications of this finding are that patients with massive HCC are typically excellent resection candidates barring the presence of gross vascular invasion or distant metastases.
BACKGROUND: A subset of patients with hepatocellular carcinoma (HCC) present with massive tumours. It is unknown why certain patients develop these massive tumours, and whether this presentation is specific to the underlying viral aetiology or patient demographics such as gender, race and age. METHODS: All patients with HCC at Bellevue Hospital Center, New York from 1998 to 2012 were identified and relevant demographic and clinical information was collected. Computed tomography/magnetic resonance imaging (CT/MRI) images were reviewed and the maximal tumour diameter on axial sections was recorded. Cirrhosis was defined histologically or by radiographical criteria. The two cohorts of massive and non-massive HCC were compared. RESULTS: A total of 361 patients with HCC were identified, of which 58 were categorized as having a massive HCC using a 13 cm size cut-off. Univariate and multivariate analysis demonstrated a significant association of massive HCC with age <40 years; hepatitis B or Asian ethnicity; and a lack of cirrhosis or platelet count >100. DISCUSSION: Massive HCC represents a tumour subtype that is associated with young, chronic hepatitis B carriers with non-cirrhotic livers. The clinical implications of this finding are that patients with massive HCC are typically excellent resection candidates barring the presence of gross vascular invasion or distant metastases.
Authors: Zhaoshi Jiang; Suchit Jhunjhunwala; Jinfeng Liu; Peter M Haverty; Michael I Kennemer; Yinghui Guan; William Lee; Paolo Carnevali; Jeremy Stinson; Stephanie Johnson; Jingyu Diao; Stacy Yeung; Adrian Jubb; Weilan Ye; Thomas D Wu; Sharookh B Kapadia; Frederic J de Sauvage; Robert C Gentleman; Howard M Stern; Somasekar Seshagiri; Krishna P Pant; Zora Modrusan; Dennis G Ballinger; Zemin Zhang Journal: Genome Res Date: 2012-01-20 Impact factor: 9.043
Authors: Yuk Pang Yeung; Chung Mau Lo; Chi Leung Liu; Benjamin C Wong; Sheung Tat Fan; John Wong Journal: Am J Gastroenterol Date: 2005-09 Impact factor: 10.864
Authors: F Trevisani; P Caraceni; M Bernardi; P E D'Intino; V Arienti; P Amorati; G F Stefanini; G Grazi; A Mazziotti; L Fornalè Journal: Cancer Date: 1993-09-01 Impact factor: 6.860
Authors: V Mazzaferro; E Regalia; R Doci; S Andreola; A Pulvirenti; F Bozzetti; F Montalto; M Ammatuna; A Morabito; L Gennari Journal: N Engl J Med Date: 1996-03-14 Impact factor: 176.079