Hepatocellular carcinoma often has a poor prognosis despite therapy. Certain clinical and pathologic features for the patient and the tumor are associated with prognosis.
Patient population used in study:
• 224 patients, 91% from North America
• 73% were > 45 years of age and 19% had cirrhosis
• all the patients had far advanced disease not amenable to surgery
Parameter
Findings Associated with Worse Prognosis
Hazard Ratio
age of patient
> 45 years
1.87
predominant histologic pattern
trabecular (including clear cell type)
1.45
histologic differentiation
poor
1.57
cirrhosis
present
.158
where:
• clear cell carcinoma was considered a variant of the trabecular pattern
Histologic patterns associated with better prognosis:
(1) pelioid
(2) spindle cell
(3) fibrolamellar
Limitations:
• Resectability was not evaluated since all patients had advanced disease.
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