Clinical manifestations and outcomes of patients with scirrhous hepatocellular carcinoma.

Affiliation

Huang SC(#)(1), Liao SH(#)(1)(2)(3), Su TH(1)(4), Jeng YM(5), Kao JH(6)(7)(8)(9).
Author information:
(1)Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
(2)Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan.
(3)Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
(4)Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan.
(5)Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan.
(6)Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. [Email]
(7)Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan. [Email]
(8)Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan. [Email]
(9)Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, 1 Chang-Te St., Taipei, 10002, Taiwan. [Email]
(#)Contributed equally

Abstract

BACKGROUND: The scirrhous hepatocellular carcinoma (HCC) is a rare subtype characterized by prominent fibrous stroma separating nests of tumor cells histologically. The clinical characteristics of scirrhous HCC have not been clearly elucidated due to limited literatures. We aimed to investigate the clinical manifestations and outcomes of patients with scirrhous HCC. METHODS: A total of 4012 patients with histologically proven HCC from the Cancer Registry Database (2004-2016) of the National Taiwan University Hospital (NTUH) were enrolled; whereas, 30 patients with scirrhous HCC were identified from the pathology database of NTUH. We matched 120 patients with non-scirrhous HCC through propensity score according to sex, age, Barcelona Clinic Liver Cancer stage and initial treatment modality for comparison. RESULTS: No significant difference in baseline characteristics and presentations was observed between the patients with scirrhous and non-scirrhous HCC except baseline alpha-fetoprotein level. The overall survival was comparable in these two groups. For the patients undergoing curative therapy, the risk of recurrence in the patients with scirrhous HCC was significantly higher within 24 months after curative therapy (hazard ratio [HR], 2.88, 95% confidence interval [CI], 1.43-5.80, p value, 0.003) as compared with those with non-scirrhous HCC. The overall recurrence rate was comparable in these two groups. CONCLUSIONS: Using propensity score matching, the risk of recurrence in the patients with scirrhous HCC was significantly higher in the first 2 years after curative therapy as compared to those with non-scirrhous HCC. An individualized post-curative treatment monitoring strategy should be considered for the patients with scirrhous HCC.