BACKGROUND & AIMS: Infiltrative hepatocellular carcinoma (iHCC) is characterized by its indistinct borders and lack of a typical pattern of contrast enhancement. There are few published data on iHCC. We assessed outcomes, effects of treatment, and prognostic factors in a large cohort of patients with iHCC. METHODS: We analyzed data from 155 patients (median age, 60 years; 79% male; median level of α-fetoprotein, 347 ng/mL; median Model for End-Stage Liver Disease score, 13) with iHCC, on the basis of contrast-enhanced computed tomography or magnetic resonance imaging, from 2002-2010 at the University of California, San Francisco Medical Center. All imaging study results were independently reviewed by 2 investigators. RESULTS: Most of the patients had tumors of Barcelona Clinic Liver Cancer stage C (70%) or D (22%). The median maximum tumor diameter was 11.3 cm; 41% of lesions were hypovascular, 82% had macrovascular invasion, and 52% had extrahepatic metastases. Median survival was 4.0 months, and rates of survival at 6 and 12 months were 30% and 10%, respectively. On multivariate analysis, predictors of 6-month mortality were Child-Pugh class B or C cirrhosis; lack of tumor-directed therapy with chemoembolization (transarterial chemoembolization), radiofrequency ablation, or sorafenib; α-fetoprotein level >1000 ng/mL; female sex; Model for End-Stage Liver Disease score; and maximum tumor diameter. The percentages of patients surviving 6 and 12 months were 17% and 2% for those who received no therapy (n = 109), 73% and 36% for those who received sorafenib (n = 11), and 45% and 17% for those who received transarterial chemoembolization (n = 18) (all P values <.01). CONCLUSIONS: Infiltrative HCC is a radiographically distinct and advanced form of hepatocellular carcinoma with a poor prognosis. Therapy with transarterial chemoembolization or sorafenib appears to prolong survival and requires further investigation.
BACKGROUND & AIMS: Infiltrative hepatocellular carcinoma (iHCC) is characterized by its indistinct borders and lack of a typical pattern of contrast enhancement. There are few published data on iHCC. We assessed outcomes, effects of treatment, and prognostic factors in a large cohort of patients with iHCC. METHODS: We analyzed data from 155 patients (median age, 60 years; 79% male; median level of α-fetoprotein, 347 ng/mL; median Model for End-Stage Liver Disease score, 13) with iHCC, on the basis of contrast-enhanced computed tomography or magnetic resonance imaging, from 2002-2010 at the University of California, San Francisco Medical Center. All imaging study results were independently reviewed by 2 investigators. RESULTS: Most of the patients had tumors of Barcelona Clinic Liver Cancer stage C (70%) or D (22%). The median maximum tumor diameter was 11.3 cm; 41% of lesions were hypovascular, 82% had macrovascular invasion, and 52% had extrahepatic metastases. Median survival was 4.0 months, and rates of survival at 6 and 12 months were 30% and 10%, respectively. On multivariate analysis, predictors of 6-month mortality were Child-Pugh class B or C cirrhosis; lack of tumor-directed therapy with chemoembolization (transarterial chemoembolization), radiofrequency ablation, or sorafenib; α-fetoprotein level >1000 ng/mL; female sex; Model for End-Stage Liver Disease score; and maximum tumor diameter. The percentages of patients surviving 6 and 12 months were 17% and 2% for those who received no therapy (n = 109), 73% and 36% for those who received sorafenib (n = 11), and 45% and 17% for those who received transarterial chemoembolization (n = 18) (all P values <.01). CONCLUSIONS: Infiltrative HCC is a radiographically distinct and advanced form of hepatocellular carcinoma with a poor prognosis. Therapy with transarterial chemoembolization or sorafenib appears to prolong survival and requires further investigation.
Authors: Aram Demirjian; Peter Peng; Jean-Francois H Geschwind; David Cosgrove; Jacob Schutz; Ihab R Kamel; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2011-07-02 Impact factor: 3.452
Authors: Peter J Kneuertz; Aram Demirjian; Amin Firoozmand; Celia Corona-Villalobos; Nikhil Bhagat; Joseph Herman; Andrew Cameron; Ahmet Gurakar; David Cosgrove; Michael A Choti; Jean-Francois H Geschwind; Ihab R Kamel; Timothy M Pawlik Journal: Ann Surg Oncol Date: 2012-04-03 Impact factor: 5.344
Authors: Omar Barakat; R Patrick Wood; Claire F Ozaki; Victor Ankoma-Sey; Joseph Galati; Mark Skolkin; Barry Toombs; Mary Round; Warren Moore; Luis Mieles Journal: Liver Transpl Date: 2010-03 Impact factor: 5.799
Authors: Sun-Jung Myung; Jung-Hwan Yoon; Kang Mo Kim; Geum-Youn Gwak; Yoon Jun Kim; Ji-Won Yu; Jin Wook Chung; Hyo-Suk Lee Journal: Hepatogastroenterology Date: 2006 Mar-Apr
Authors: Francis Y Yao; Robert K Kerlan; Ryutaro Hirose; Timothy J Davern; Nathan M Bass; Sandy Feng; Marion Peters; Norah Terrault; Chris E Freise; Nancy L Ascher; John P Roberts Journal: Hepatology Date: 2008-09 Impact factor: 17.425
Authors: Josep M Llovet; Adrian M Di Bisceglie; Jordi Bruix; Barnett S Kramer; Riccardo Lencioni; Andrew X Zhu; Morris Sherman; Myron Schwartz; Michael Lotze; Jayant Talwalkar; Gregory J Gores Journal: J Natl Cancer Inst Date: 2008-05-13 Impact factor: 13.506
Authors: Josep M Llovet; Sergio Ricci; Vincenzo Mazzaferro; Philip Hilgard; Edward Gane; Jean-Frédéric Blanc; Andre Cosme de Oliveira; Armando Santoro; Jean-Luc Raoul; Alejandro Forner; Myron Schwartz; Camillo Porta; Stefan Zeuzem; Luigi Bolondi; Tim F Greten; Peter R Galle; Jean-François Seitz; Ivan Borbath; Dieter Häussinger; Tom Giannaris; Minghua Shan; Marius Moscovici; Dimitris Voliotis; Jordi Bruix Journal: N Engl J Med Date: 2008-07-24 Impact factor: 91.245
Authors: Meaghan S Dendy; Juan C Camacho; Johannes M Ludwig; Alyssa M Krasinskas; Stuart J Knechtle; Hyun S Kim Journal: Transplant Direct Date: 2017-08-18