Diffuse Infiltrative Hepatocellular Carcinoma: Assessment of Presentation, Treatment, and Outcomes |
| |
| Authors: | Peter J Kneuertz MD Aram Demirjian MD Amin Firoozmand MD Celia Corona-Villalobos MD Nikhil Bhagat MD Joseph Herman MD Andrew Cameron MD Ahmet Gurakar MD David Cosgrove MD Michael A Choti MD Jean-Francois H Geschwind MD Ihab R Kamel MD Timothy M Pawlik MD MPH |
| |
| Institution: | Department of Surgery, Liver Tumor Center, Johns Hopkins University School of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. |
| |
| Abstract: | Background Data on infiltrating hepatocellular carcinoma (HCC) are limited. We sought to define treatment and outcome of patients treated with infiltrating HCC compared with patients who had advanced multifocal HCC. Methods Between January 2000 and July 2011, a total of 147 patients with advanced HCC were identified from the Johns Hopkins Hospital database (infiltrative, n?=?75; multifocal, n?=?72). Clinicopathologic data were compared by HCC subtype. Results Patients with infiltrating HCC had higher alfa-fetoprotein levels (median infiltrative, 326.5?ng/mL vs. multifocal, 27.0?ng/mL) and larger tumors (median size, infiltrating, 9.2?cm vs. multifocal, 5.5?cm) (P?P?=?0.001). Survival after IAT was similar among patients treated with infiltrating HCC versus multifocal HCC (hazard ratio 1.29, 95?% confidence interval 0.82?C2.03; P?=?0.27). Among infiltrating HCC patients, pretreatment bilirubin >2?mg/dL and alfa-fetoprotein >400?ng/mL were associated with worse survival after IAT (P?P?=?0.004). Conclusions Patients with infiltrative HCC often present without a discrete lesion on imaging. IAT for infiltrative HCC was safe and was associated with survival comparable to IAT outcomes for patients with multifocal HCC. Infiltrative HCC morphology is not a contraindication to IAT therapy in select patients. |
| |
| Keywords: | |
| 本文献已被 PubMed SpringerLink 等数据库收录！ |
|
