Natural history and treatment trends in hepatocellular carcinoma subtypes: Insights from a national cancer registry.

摘要: Background Histopathologic advancements have identified several rare subtypes of hepatocellular carcinoma (HCC), but the clinical significance these distinctions is incompletely understood. Our aim was to investigate pathologic and treatment differences between HCC variants. Methods The American College Surgeons National Cancer Data Base (1998–2011) queried identify 784 patients with surgical management six subtypes: fibrolamellar (FL, n = 206), scirrhous (SC, n = 29), spindle cell (SP, n = 20), clear (CC, n = 169), mixed type (M, n = 291), trabecular (T, n = 69). We examined associations demographic, tumor treatment-specific variables, overall survival (OS). Results Patients FL-HCC were younger than other variants (median age 27 vs. 54–61, P  5 cm, P < 0.001) node-positive disease (P < 0.001). Better OS associated lower stage, node-negative disease, FL-HCC, liver transplant. Adjuvant therapy (11% patients) not better OS. Conclusions This largest series recognized demonstrates distinct in presentation, treatment, prognosis. These findings can provide a valuable reference for clinicians who encounter entities. J. Surg. Oncol. 2015;112:872–876. © 2015 Wiley Periodicals, Inc.