Rui Caetano Oliveira1,2,3, Ricardo Martins4,5,6,7,8, Ana Margarida Abrantes4,5, Ângela Jesus9, Paulo Teixeira9, Carolina Canhoto6, Pedro Guerreiro6, Beatriz Costa5,6,7, Mário Rui Silva9, José Guilherme Tralhão6,7,8, Maria Augusta Cipriano9. 1. Serviço de Anatomia Patológica, Pathology Department, Centro Hospitalar e Universitário de Coimbra, Piso-3, Praceta Mota Pinto, 3000-075, Coimbra, Portugal. ruipedrocoliveira@hotmail.com. 2. Biophysics Institute, Faculty of Medicine, University of Coimbra, Coimbra, Portugal. ruipedrocoliveira@hotmail.com. 3. Coimbra Institute for Clinical and Biomedical Research (iCBR) Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal. ruipedrocoliveira@hotmail.com. 4. Biophysics Institute, Faculty of Medicine, University of Coimbra, Coimbra, Portugal. 5. Coimbra Institute for Clinical and Biomedical Research (iCBR) Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal. 6. Surgery Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. 7. Faculty of Medicine, University of Coimbra, Coimbra, Portugal. 8. Pediatric and Adult Liver Transplantation Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. 9. Serviço de Anatomia Patológica, Pathology Department, Centro Hospitalar e Universitário de Coimbra, Piso-3, Praceta Mota Pinto, 3000-075, Coimbra, Portugal.
Abstract
BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide and the third cause of cancer-related death. Current clinical/pathological criteria contribute to risk stratification, but are far from the desired on individualized medicine. Recently, HCC classifications have been published based on immunohistochemical and morphological features. METHODS: A retrospective review of patients submitted to surgical treatment-partial hepatectomy (PH) or liver transplantation (LT), with pathological diagnosis of HCC, in a 9-year period (2007-2015) was performed. RESULTS: Applying the classification of Srivastava et al. (#1), based on the expression of CD31, p53, AFP and CD44, tumour size and presence of vascular invasion, HCC were categorized as low- and high-risk HCC. With the classification of Tsujikawa et al. (#2), HCC were classified into biliary/stem cell marker positive, Wnt signalling positive and the "all negative" HCC, according to the expression of CK19, SALL4, β-catenin glutamine synthetase, EpCAM and p53. There were sixty-six patients (53 males; 13 females), with median age of 64.5 ± 9.46 years (range 38-86), with solitary HCC, comprehending 37 PH (56.1%) and 29 LT (43.9%). The mean overall survival (OS) was 75.4 ± 6.9 months. Biliary/stem cell type of HCC was a predictive factor of worse OS on the overall population (24.4 versus 78.3 months, p = 0.032) and in PH cohort (11.5 versus 64.01 months, p = 0.016), on uni- and multivariate analyses. CONCLUSION: These results support the relevance of a risk stratification classification of HCC. Classification #2 seems adequate to our reality demonstrating OS impact, allowing its application in future biopsies, prompting individualized medicine.
BACKGROUND:Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide and the third cause of cancer-related death. Current clinical/pathological criteria contribute to risk stratification, but are far from the desired on individualized medicine. Recently, HCC classifications have been published based on immunohistochemical and morphological features. METHODS: A retrospective review of patients submitted to surgical treatment-partial hepatectomy (PH) or liver transplantation (LT), with pathological diagnosis of HCC, in a 9-year period (2007-2015) was performed. RESULTS: Applying the classification of Srivastava et al. (#1), based on the expression of CD31, p53, AFP and CD44, tumour size and presence of vascular invasion, HCC were categorized as low- and high-risk HCC. With the classification of Tsujikawa et al. (#2), HCC were classified into biliary/stem cell marker positive, Wnt signalling positive and the "all negative" HCC, according to the expression of CK19, SALL4, β-catenin glutamine synthetase, EpCAM and p53. There were sixty-six patients (53 males; 13 females), with median age of 64.5 ± 9.46 years (range 38-86), with solitary HCC, comprehending 37 PH (56.1%) and 29 LT (43.9%). The mean overall survival (OS) was 75.4 ± 6.9 months. Biliary/stem cell type of HCC was a predictive factor of worse OS on the overall population (24.4 versus 78.3 months, p = 0.032) and in PH cohort (11.5 versus 64.01 months, p = 0.016), on uni- and multivariate analyses. CONCLUSION: These results support the relevance of a risk stratification classification of HCC. Classification #2 seems adequate to our reality demonstrating OS impact, allowing its application in future biopsies, prompting individualized medicine.
Authors: Freddie Bray; Jacques Ferlay; Isabelle Soerjomataram; Rebecca L Siegel; Lindsey A Torre; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2018-09-12 Impact factor: 508.702
Authors: Jin Un Kim; Mohamed I F Shariff; Mary M E Crossey; Maria Gomez-Romero; Elaine Holmes; I Jane Cox; Haddy K S Fye; Ramou Njie; Simon D Taylor-Robinson Journal: World J Hepatol Date: 2016-04-08
Authors: S Srivastava; K F Wong; C W Ong; C Y Huak; K G Yeoh; M Teh; J M Luk; M Salto-Tellez Journal: Br J Cancer Date: 2012-06-19 Impact factor: 7.640