Tumor size predicts vascular invasion and histologic grade
Vascular invasion and high histologic grade predict poor outcome after surgical resection or liver transplantation for hepatocellular carcinoma (HCC). Despite the known association between tumor size and vascular invasion, a proportion of patients with large tumors can be treated surgically with exc...
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| Other Authors: | , , , , , , , , , |
| Format: | article |
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2005
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| Online Access: | http://hdl.handle.net/10725/2535 http://dx.doi.org/10.1002/lt.20472 http://onlinelibrary.wiley.com/doi/10.1002/lt.20472/full |
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| _version_ | 1864513458599362561 |
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| author | Abdalla, Eddie |
| author2 | Pawlik, Timothy Delman, Keith Vauthey, Nicolas Nagorney, David Oi-Lin Ng, Irene Yamaoka, Yoshio Ikai, Iwao Belghiti, Jacques Lauwers, Gregory Poon, Ronnie |
| author2_role | author author author author author author author author author author |
| author_facet | Abdalla, Eddie Pawlik, Timothy Delman, Keith Vauthey, Nicolas Nagorney, David Oi-Lin Ng, Irene Yamaoka, Yoshio Ikai, Iwao Belghiti, Jacques Lauwers, Gregory Poon, Ronnie |
| author_role | author |
| dc.creator.none.fl_str_mv | Abdalla, Eddie Pawlik, Timothy Delman, Keith Vauthey, Nicolas Nagorney, David Oi-Lin Ng, Irene Yamaoka, Yoshio Ikai, Iwao Belghiti, Jacques Lauwers, Gregory Poon, Ronnie |
| dc.date.none.fl_str_mv | 2005 2015-11-11T12:44:15Z 2015-11-11T12:44:15Z 2015-11-11 |
| dc.identifier.none.fl_str_mv | 1527-6465 http://hdl.handle.net/10725/2535 http://dx.doi.org/10.1002/lt.20472 Pawlik, T. M., Delman, K. A., Vauthey, J. N., Nagorney, D. M., Ng, I. O. L., Ikai, I., ... & Abdalla, E. K. (2005). Tumor size predicts vascular invasion and histologic grade: implications for selection of surgical treatment for hepatocellular carcinoma. Liver Transplantation, 11(9), 1086-1092. http://onlinelibrary.wiley.com/doi/10.1002/lt.20472/full |
| dc.language.none.fl_str_mv | en |
| dc.relation.none.fl_str_mv | Liver Transplantation |
| dc.rights.*.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.title.none.fl_str_mv | Tumor size predicts vascular invasion and histologic grade Implications for selection of surgical treatment for hepatocellular carcinoma |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | Vascular invasion and high histologic grade predict poor outcome after surgical resection or liver transplantation for hepatocellular carcinoma (HCC). Despite the known association between tumor size and vascular invasion, a proportion of patients with large tumors can be treated surgically with excellent outcomes. Clarification of the association between tumor size, histologic grade, and vascular invasion has implications for patient selection for resection and transplantation. The objective of this study was to examine the relationship between HCC tumor size and microscopic (occult) vascular invasion and histologic grade in a multicenter international database of 1,073 patients who underwent resection of HCC. The incidence of microscopic vascular invasion increased with tumor size (≤3 cm, 25%; 3.1-5 cm, 40%; 5.1-6.5 cm, 55%; >6.5 cm, 63%) (P < 0.005). Both size and number of tumors were important factors predicting vascular invasion. Among all patients with tumors 5.1 to 6.5 cm, microscopic vascular invasion was present in 55% compared with 31% for all patients with tumors 5 cm or smaller (P < 0.001). Among patients with solitary tumors only, microscopic vascular invasion was significantly more common in tumors measuring 5.1 to 6.5 cm (41%) compared with 27% of tumors 5 cm or smaller (P < 0.003). Tumor size also predicted histologic grade: 36% of tumors 5 cm or smaller were high grade, compared with 54% of lesions 5.1 to 6.5 cm (P = 0.01). High histologic grade, an alpha-fetoprotein level of at least 1000 ng/mL, and multiple tumor nodules each predicted occult vascular invasion in tumors larger than 5 cm. The high incidence of occult vascular invasion and advanced histologic grade in HCC tumors larger than 5 cm, as well as biologic predictors of poor prognosis, should be considered before criteria for transplantation are expanded to include these patients. (Liver Transpl 2005;11:1086–1092.) |
| eu_rights_str_mv | openAccess |
| format | article |
| id | LAURepo_57384c3a11ddda30e1d6e89f02442121 |
| identifier_str_mv | 1527-6465 Pawlik, T. M., Delman, K. A., Vauthey, J. N., Nagorney, D. M., Ng, I. O. L., Ikai, I., ... & Abdalla, E. K. (2005). Tumor size predicts vascular invasion and histologic grade: implications for selection of surgical treatment for hepatocellular carcinoma. Liver Transplantation, 11(9), 1086-1092. |
| language_invalid_str_mv | en |
| network_acronym_str | LAURepo |
| network_name_str | Lebanese American University repository |
| oai_identifier_str | oai:laur.lau.edu.lb:10725/2535 |
| publishDate | 2005 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| spelling | Tumor size predicts vascular invasion and histologic gradeImplications for selection of surgical treatment for hepatocellular carcinomaAbdalla, EddiePawlik, TimothyDelman, KeithVauthey, NicolasNagorney, DavidOi-Lin Ng, IreneYamaoka, YoshioIkai, IwaoBelghiti, JacquesLauwers, GregoryPoon, RonnieVascular invasion and high histologic grade predict poor outcome after surgical resection or liver transplantation for hepatocellular carcinoma (HCC). Despite the known association between tumor size and vascular invasion, a proportion of patients with large tumors can be treated surgically with excellent outcomes. Clarification of the association between tumor size, histologic grade, and vascular invasion has implications for patient selection for resection and transplantation. The objective of this study was to examine the relationship between HCC tumor size and microscopic (occult) vascular invasion and histologic grade in a multicenter international database of 1,073 patients who underwent resection of HCC. The incidence of microscopic vascular invasion increased with tumor size (≤3 cm, 25%; 3.1-5 cm, 40%; 5.1-6.5 cm, 55%; >6.5 cm, 63%) (P < 0.005). Both size and number of tumors were important factors predicting vascular invasion. Among all patients with tumors 5.1 to 6.5 cm, microscopic vascular invasion was present in 55% compared with 31% for all patients with tumors 5 cm or smaller (P < 0.001). Among patients with solitary tumors only, microscopic vascular invasion was significantly more common in tumors measuring 5.1 to 6.5 cm (41%) compared with 27% of tumors 5 cm or smaller (P < 0.003). Tumor size also predicted histologic grade: 36% of tumors 5 cm or smaller were high grade, compared with 54% of lesions 5.1 to 6.5 cm (P = 0.01). High histologic grade, an alpha-fetoprotein level of at least 1000 ng/mL, and multiple tumor nodules each predicted occult vascular invasion in tumors larger than 5 cm. The high incidence of occult vascular invasion and advanced histologic grade in HCC tumors larger than 5 cm, as well as biologic predictors of poor prognosis, should be considered before criteria for transplantation are expanded to include these patients. (Liver Transpl 2005;11:1086–1092.)PublishedN/A2015-11-11T12:44:15Z2015-11-11T12:44:15Z20052015-11-11Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article1527-6465http://hdl.handle.net/10725/2535http://dx.doi.org/10.1002/lt.20472Pawlik, T. M., Delman, K. A., Vauthey, J. N., Nagorney, D. M., Ng, I. O. L., Ikai, I., ... & Abdalla, E. K. (2005). Tumor size predicts vascular invasion and histologic grade: implications for selection of surgical treatment for hepatocellular carcinoma. Liver Transplantation, 11(9), 1086-1092.http://onlinelibrary.wiley.com/doi/10.1002/lt.20472/fullenLiver Transplantationinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/25352019-02-26T11:16:27Z |
| spellingShingle | Tumor size predicts vascular invasion and histologic grade Abdalla, Eddie |
| status_str | publishedVersion |
| title | Tumor size predicts vascular invasion and histologic grade |
| title_full | Tumor size predicts vascular invasion and histologic grade |
| title_fullStr | Tumor size predicts vascular invasion and histologic grade |
| title_full_unstemmed | Tumor size predicts vascular invasion and histologic grade |
| title_short | Tumor size predicts vascular invasion and histologic grade |
| title_sort | Tumor size predicts vascular invasion and histologic grade |
| url | http://hdl.handle.net/10725/2535 http://dx.doi.org/10.1002/lt.20472 http://onlinelibrary.wiley.com/doi/10.1002/lt.20472/full |