Fibrolamellar Carcinoma: Novel Insights into a Rare Subtype

Excerpt

We read with interest the retrospective analysis by McDonald et al. utilizing the National Cancer Database (NCDB) and describing the outcomes of 496 patients with fibrolamellar carcinoma (FLC), specifically 229 patients who underwent R0/R1 resection or transplantation.1 We commend them on aggregating a sizable number of patients with an uncommon tumor histology over an 11-year period, as most reports on FLC are from a single institution and of low volume. McDonald et al. demonstrated poor prognostic factors, such as multiple tumors and positive nodal status, which is consistent with other reported studies; however, they also reported that 44% of FLC patients had elevated α-fetoprotein (AFP), which is significantly higher than the 0–10% previously reported. The authors show a significantly worse prognosis in FLC patients with elevated AFP, which is a novel finding for this rare subtype. …