Skip to main content
SpringerLink
Log in

Clinicopathologic Characteristics and Long-Term Prognosis of Scirrhous Hepatocellular Carcinoma

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Background

Clinicopathologic features and long-term outcomes in patients with scirrhous hepatocellular carcinoma (S-HCC) are not fully defined.

Methods

We compared data of 37 patients with S-HCC and 604 with usual HCC (U-HCC) undergoing surgery.

Results

The S-HCC group showed less HBV infection (78.4 vs. 92.0%, P = 0.02), low serum AFP level (2320 ± 6356 vs. 3297 ± 18690 ng/ml, P < 0.0001), less delayed washout during CT (72.7 vs. 90.7%, P = 0.004), and low usefulness of clinical diagnostic criteria (32.4 vs. 57.5%, P = 0.003), compared to the U-HCC group. More portal vein invasion (18.9 vs. 4.1%, P = 0.03) and less liver cirrhosis (35.1 vs. 65.1%, P = 0.001) and fibrous capsule (40.5 vs. 81.6%, P < 0.001) were noted in the S-HCC group than the U-HCC group. Long-term survival rates were similar between the S-HCC and U-HCC groups, even with subgroup analysis according to Child-Pugh score and modified UICC stage.

Conclusion

The S-HCC group showed distinct patient and tumor characteristics but similar long-term outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Matsuura S, Aishima S, Taguchi K, et al. ‘Scirrhous’ type hepatocellular carcinomas: a special reference to expression of cytokeratin 7 and hepatocyte paraffin 1. Histopathology. 2005;47:382–390.

    Article  PubMed  CAS  Google Scholar 

  2. Kurogi M, Nakashima O, Miyaaki H, Fujimoto M, Kojiro M. Clinicopathological study of scirrhous hepatocellular carcinoma. J Gastroenterol Hepatol. 2006;21:1470–1477.

    PubMed  Google Scholar 

  3. Ishak KG, Goodman Z, Stocker JT. Hepatocellular carcinoma. In: Rosai J, Sobin LH, eds. Tumors of the Liver and Intrahepatic Bile Duct. 3rd ed. Washington, DC: Armed Forces Institute of Pathology; 1999:199–230.

    Google Scholar 

  4. Iha H. Clinicopathological study on scirrhous hepatocellular carcinoma. A study of 12 resected cases. Acta Hepatol Jpn. 1994;28:855–863.

    Article  Google Scholar 

  5. Japan LCSGO. Survey and Follow-Up Study of Primary Liver Cancer in Japan. Report 15. Kyoto: Liver Cancer Study group of Japan; 2002.

  6. Kim SH, Lee WJ, Lim HK, Park CK. Sclerosing hepatic carcinoma: helical CT features. Abdom Imaging. 2007;32:725–729.

    Article  Google Scholar 

  7. Goshima S, Kanematsu M, Yamada T, et al. Small scirrhous hepatocellular carcinoma with central scar: MR imaging findings. J Magn Reson Imaging. 2002;16:741–745.

    Article  PubMed  Google Scholar 

  8. Yamashita Y, Fan ZM, Yamamoto H, et al. Sclerosing hepatocellular carcinoma: radiologic findings. Abdom Imaging. 1993;18:347–351.

    Article  PubMed  CAS  Google Scholar 

  9. Yoshida J, Takayama T, Yamamoto H. Computed tomography of sclerosing hepatocellular carcinoma. Comput Med Imaging Graph. 1992;16:125–130.

    Article  PubMed  CAS  Google Scholar 

  10. Kim SR, Imoto S, Nakajima T, et al. Scirrhous hepatocellular carcinoma displaying atypical findings on imaging studies. World J Gastroenterol. 2009;15:2296–2299.

    Article  PubMed  Google Scholar 

  11. Kim SH, Lim HK, Lee WJ, Choi D, Park CK. Scirrhous hepatocellular carcinoma: comparison with usual hepatocellular carcinoma based on CT-pathologic features and long-term results after curative resection. Eur J Radiol. 2009;69:123–130.

    Article  PubMed  Google Scholar 

  12. Sugiki T, Yamamoto M, Taka K, Nakano M. Specific characteristics of scirrhous hepatocellular carcinoma. Hepatogastroenterology. 2009;56:1086–1089.

    PubMed  Google Scholar 

  13. Bruix J, Sherman M, Llovet JM, et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol. 2001;35:421–430.

    Article  PubMed  CAS  Google Scholar 

  14. Bruis J, Sherman M. AASLD practice guideline: management of hepatocellular carcinoma. Hepatology. 2005;42:1209–1235.

    Google Scholar 

  15. International Union Against Cancer (UICC). In: Sobin LH, Wittekind C, eds. TNM Classification of Malignant Tumors. 5th ed. New York. Wiley-Liss; 1997.

  16. Christensen E. Prognostic models including the Child-Pugh, MELD and Mayo risk scores—where are we and where should we go? J Hepatol. 2004;41:344–350.

    Article  PubMed  Google Scholar 

  17. Okamura N, Yoshida M, Shibuya A, Sugiura H, Okayasu I, Ohbu M. Cellular and stromal characteristics in the scirrhous hepatocellular carcinoma: comparison with hepatocellular carcinomas and intrahepatic cholangiocarcinomas. Pathol Int. 2005;55:724–731.

    Article  PubMed  CAS  Google Scholar 

  18. Chu PG, Ishizawa S, Wu E, Weiss LM. Hepatocyte antigen as a marker of hepatocellular carcinoma: an immunohistochemical comparison to carcinoembryonic antigen, CD10, and alpha-fetoprotein. Am J Surg Pathol. 2002;26:978–988.

    Article  PubMed  Google Scholar 

  19. Yeh CN, Hung CF, Lee KF, Chen MF. Sclerosing hepatocellular carcinoma: clinicopathologic features in seven patients from Taiwan and review of the literature. Hepatogastroenterology. 2005;52:1201–1205.

    PubMed  Google Scholar 

  20. Kim BS, Lee SG, Hwang S, et al. Surgical treatment of sclerosing hepatocellular carcinoma. Korean J Hepatol. 2006;12:412–419.

    PubMed  Google Scholar 

  21. Ikai I, Itai Y, Okita K, et al. Report of the 15th follow-up survey of primary liver cancer. Hepatol Res. 2004;28:21–29.

    Article  PubMed  Google Scholar 

  22. Asayama Y, Yoshimitsu K, Irie H, et al. Delayed-phase dynamic CT enhancement as a prognostic factor for mass-forming intrahepatic cholangiocarcinoma. Radiology. 2006;238:150–155.

    Article  PubMed  Google Scholar 

  23. Valls C, Guma A, Puig I, et al. Intrahepatic peripheral cholangiocarcinoma: CT evaluation. Abdom Imaging. 2000;25:490–496.

    Article  PubMed  CAS  Google Scholar 

  24. Yoshikawa J, Matsui O, Kadoya M, Gabata T, Arai K, Takashima T. Delayed enhancement of fibrotic areas in hepatic masses: CT-pathologic correlation. J Comput Assist Tomogr. 1992;16:206–211.

    Article  PubMed  CAS  Google Scholar 

  25. Jeon TY, Kim SH, Lee WJ, Lim HK. The value of gadobenate dimeglumine-enhanced hepatobiliary-phase MR imaging for the differentiation of scirrhous hepatocellular carcinoma and cholangiocarcinoma with or without hepatocellular carcinoma. Abdom Imaging. 2010;35:337–345.

    Article  PubMed  Google Scholar 

  26. Yamashita Y, Fan ZM, Yamamoto H, et al. Spin-echo and dynamic gadolinium-enhanced FLASH MR imaging of hepatocellular carcinoma: correlation with histopathologic findings. J Magn Reson Imaging. 1994;4:83–90.

    Article  PubMed  CAS  Google Scholar 

  27. Troeger JS, Schwabe RF. Hypoxia and hypoxia-inducible factor 1alpha: potential links between angiogenesis and fibrogenesis in hepatic stellate cells. Liver Int. 2011;31:143–145.

    Article  PubMed  Google Scholar 

  28. Copple BL, Bai S, Burgoon LD, Moon JO. Hypoxia-inducible factor-1alpha regulates the expression of genes in hypoxic hepatic stellate cells important for collagen deposition and angiogenesis. Liver Int. 2011;31:230–244.

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-Dong 50, Gangnam-Gu, Seoul, 135-710, Korea

    Jin Hee Lee, Moon Seok Choi, Geum Yeon Gwak, Joon Hyeok Lee, Kwang Cheol Koh, Seung Woon Paik & Byung Chul Yoo

  2. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Dongil Choi

  3. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Cheol Keun Park

Authors
  1. Jin Hee Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Moon Seok Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Geum Yeon Gwak
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Joon Hyeok Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kwang Cheol Koh
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Seung Woon Paik
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Byung Chul Yoo
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Dongil Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Cheol Keun Park
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Moon Seok Choi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lee, J.H., Choi, M.S., Gwak, G.Y. et al. Clinicopathologic Characteristics and Long-Term Prognosis of Scirrhous Hepatocellular Carcinoma. Dig Dis Sci 57, 1698–1707 (2012). https://doi.org/10.1007/s10620-012-2075-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-012-2075-x

Keywords

Search

Navigation