Prognostic significance of the worst grade in hepatocellular carcinoma with heterogeneous histologic grades of differentiation

Dai Hoon Han, Gi Hong Choi, Kyung Sik Kim, Jin Sub Choi, Young Nyun Park, Seung Up Kim, Jun Yong Park, Sang Hoon Ahn, Kwang Hyub Han

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27 Citations (Scopus)

Abstract

Background and Aim: Although tumor differentiation is a known prognostic factor after the treatment of hepatocellular carcinoma (HCC), there have not been any studies on the prognostic significance of tumor differentiation in HCC with heterogeneous histologic grades. In this study, we attempted to ascertain whether the major or the worst grade in mixed histologic type HCC determines the prognosis after liver resection. Methods: From January 1996 to March 2010, a total of 724 patients underwent curative resection of HCC at Yonsei University Health System, Korea. Of those, we excluded 99 patients who had total necrosis because of previous treatment. Among the remaining 625 patients, we compared the homogeneous moderately differentiated group (HG2, n=241), mixed histologic grades with the worst component as poorly differentiated group (M2, n=142), and homogeneous poorly differentiated group (HG3, n=156). The clinicopathologic features, disease-free survival (DFS) and overall survival (OS) in each group were analyzed. Results: The DFS and OS were significantly lower in M2 than in HG2 (P=0.004 and 0.025, respectively) whereas those of M2 were not significantly different from HG3. There were no significant differences in the clinicopathologic features of each group except that microvascular invasion was more frequently observed in M2 than in HG2. On multivariate analysis, being in the worst histologic group (M2 and HG3) was an independent poor prognostic factor for DFS and OS (P=0.028 and <0.001, respectively). Conclusions: In patients with advanced histologic grade, the worst histologic grade may determine the prognosis after curative resection of HCC.

Original languageEnglish
Pages (from-to)1384-1390
Number of pages7
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume28
Issue number8
DOIs
Publication statusPublished - 2013 Aug

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Hepatocellular Carcinoma
Disease-Free Survival
Survival
Korea
Neoplasms
Necrosis
Multivariate Analysis
Liver
Health
Therapeutics

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

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title = "Prognostic significance of the worst grade in hepatocellular carcinoma with heterogeneous histologic grades of differentiation",
abstract = "Background and Aim: Although tumor differentiation is a known prognostic factor after the treatment of hepatocellular carcinoma (HCC), there have not been any studies on the prognostic significance of tumor differentiation in HCC with heterogeneous histologic grades. In this study, we attempted to ascertain whether the major or the worst grade in mixed histologic type HCC determines the prognosis after liver resection. Methods: From January 1996 to March 2010, a total of 724 patients underwent curative resection of HCC at Yonsei University Health System, Korea. Of those, we excluded 99 patients who had total necrosis because of previous treatment. Among the remaining 625 patients, we compared the homogeneous moderately differentiated group (HG2, n=241), mixed histologic grades with the worst component as poorly differentiated group (M2, n=142), and homogeneous poorly differentiated group (HG3, n=156). The clinicopathologic features, disease-free survival (DFS) and overall survival (OS) in each group were analyzed. Results: The DFS and OS were significantly lower in M2 than in HG2 (P=0.004 and 0.025, respectively) whereas those of M2 were not significantly different from HG3. There were no significant differences in the clinicopathologic features of each group except that microvascular invasion was more frequently observed in M2 than in HG2. On multivariate analysis, being in the worst histologic group (M2 and HG3) was an independent poor prognostic factor for DFS and OS (P=0.028 and <0.001, respectively). Conclusions: In patients with advanced histologic grade, the worst histologic grade may determine the prognosis after curative resection of HCC.",
author = "Han, {Dai Hoon} and Choi, {Gi Hong} and Kim, {Kyung Sik} and Choi, {Jin Sub} and Park, {Young Nyun} and Kim, {Seung Up} and Park, {Jun Yong} and Ahn, {Sang Hoon} and Han, {Kwang Hyub}",
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Prognostic significance of the worst grade in hepatocellular carcinoma with heterogeneous histologic grades of differentiation. / Han, Dai Hoon; Choi, Gi Hong; Kim, Kyung Sik; Choi, Jin Sub; Park, Young Nyun; Kim, Seung Up; Park, Jun Yong; Ahn, Sang Hoon; Han, Kwang Hyub.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 28, No. 8, 08.2013, p. 1384-1390.

Research output: Contribution to journalArticle

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T1 - Prognostic significance of the worst grade in hepatocellular carcinoma with heterogeneous histologic grades of differentiation

AU - Han, Dai Hoon

AU - Choi, Gi Hong

AU - Kim, Kyung Sik

AU - Choi, Jin Sub

AU - Park, Young Nyun

AU - Kim, Seung Up

AU - Park, Jun Yong

AU - Ahn, Sang Hoon

AU - Han, Kwang Hyub

PY - 2013/8

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N2 - Background and Aim: Although tumor differentiation is a known prognostic factor after the treatment of hepatocellular carcinoma (HCC), there have not been any studies on the prognostic significance of tumor differentiation in HCC with heterogeneous histologic grades. In this study, we attempted to ascertain whether the major or the worst grade in mixed histologic type HCC determines the prognosis after liver resection. Methods: From January 1996 to March 2010, a total of 724 patients underwent curative resection of HCC at Yonsei University Health System, Korea. Of those, we excluded 99 patients who had total necrosis because of previous treatment. Among the remaining 625 patients, we compared the homogeneous moderately differentiated group (HG2, n=241), mixed histologic grades with the worst component as poorly differentiated group (M2, n=142), and homogeneous poorly differentiated group (HG3, n=156). The clinicopathologic features, disease-free survival (DFS) and overall survival (OS) in each group were analyzed. Results: The DFS and OS were significantly lower in M2 than in HG2 (P=0.004 and 0.025, respectively) whereas those of M2 were not significantly different from HG3. There were no significant differences in the clinicopathologic features of each group except that microvascular invasion was more frequently observed in M2 than in HG2. On multivariate analysis, being in the worst histologic group (M2 and HG3) was an independent poor prognostic factor for DFS and OS (P=0.028 and <0.001, respectively). Conclusions: In patients with advanced histologic grade, the worst histologic grade may determine the prognosis after curative resection of HCC.

AB - Background and Aim: Although tumor differentiation is a known prognostic factor after the treatment of hepatocellular carcinoma (HCC), there have not been any studies on the prognostic significance of tumor differentiation in HCC with heterogeneous histologic grades. In this study, we attempted to ascertain whether the major or the worst grade in mixed histologic type HCC determines the prognosis after liver resection. Methods: From January 1996 to March 2010, a total of 724 patients underwent curative resection of HCC at Yonsei University Health System, Korea. Of those, we excluded 99 patients who had total necrosis because of previous treatment. Among the remaining 625 patients, we compared the homogeneous moderately differentiated group (HG2, n=241), mixed histologic grades with the worst component as poorly differentiated group (M2, n=142), and homogeneous poorly differentiated group (HG3, n=156). The clinicopathologic features, disease-free survival (DFS) and overall survival (OS) in each group were analyzed. Results: The DFS and OS were significantly lower in M2 than in HG2 (P=0.004 and 0.025, respectively) whereas those of M2 were not significantly different from HG3. There were no significant differences in the clinicopathologic features of each group except that microvascular invasion was more frequently observed in M2 than in HG2. On multivariate analysis, being in the worst histologic group (M2 and HG3) was an independent poor prognostic factor for DFS and OS (P=0.028 and <0.001, respectively). Conclusions: In patients with advanced histologic grade, the worst histologic grade may determine the prognosis after curative resection of HCC.

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