Tumor size predicts vascular invasion and histologic grade

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dc.contributor.author Abdalla, Eddie
dc.contributor.author Pawlik, Timothy
dc.contributor.author Delman, Keith
dc.contributor.author Vauthey, Nicolas
dc.contributor.author Nagorney, David
dc.contributor.author Oi-Lin Ng, Irene
dc.contributor.author Yamaoka, Yoshio
dc.contributor.author Ikai, Iwao
dc.contributor.author Belghiti, Jacques
dc.contributor.author Lauwers, Gregory
dc.contributor.author Poon, Ronnie
dc.date.accessioned 2015-11-11T12:44:15Z
dc.date.available 2015-11-11T12:44:15Z
dc.date.copyright 2005
dc.date.issued 2015-11-11
dc.identifier.issn 1527-6465 en_US
dc.identifier.uri http://hdl.handle.net/10725/2535
dc.description.abstract 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.) en_US
dc.language.iso en en_US
dc.title Tumor size predicts vascular invasion and histologic grade en_US
dc.type Article en_US
dc.description.version Published en_US
dc.title.subtitle Implications for selection of surgical treatment for hepatocellular carcinoma en_US
dc.author.school SOM en_US
dc.author.idnumber 201100945 en_US
dc.author.woa N/A en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Liver Transplantation en_US
dc.journal.volume 11 en_US
dc.journal.issue 9 en_US
dc.article.pages 1086-1092 en_US
dc.identifier.doi http://dx.doi.org/10.1002/lt.20472 en_US
dc.identifier.ctation 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. en_US
dc.author.email eddie.abdalla@lau.edu.lb
dc.identifier.url http://onlinelibrary.wiley.com/doi/10.1002/lt.20472/full

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