Published in:
01-04-2005 | Editorial
Surgically Resected Hepatocellular Carcinoma: Protean Yet Predictable
Authors:
Jean-Nicolas Vauthey, MD, Gregory Y. Lauwers, MD
Published in:
Annals of Surgical Oncology
|
Issue 4/2005
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Excerpt
In this issue of the
Annals of Surgical Oncology, Ramacciato et al.
1 report the results of a study in which they evaluated the new (6th edition) American Joint Committee on Cancer and International Union Against Cancer (AJCC/UICC) staging system for hepatocellular carcinoma (HCC) in a series of 112 patients undergoing resection for HCC. The authors report a homogeneous group of patients (90% had cirrhosis, and 55% had cirrhosis induced by hepatitis C) with small (median tumor size, 4 cm) and solitary HCC (82% of patients). Microscopic vascular invasion was present in only 23 patients (21%). The authors conclude that the 6th edition AJCC/UICC staging system is superior to the preceding one because of its simplicity and more accurate stratification of patients into homogeneous subsets with similar prognosis. In agreement with the evaluation by Poon and Fan,
2 the authors found no improved prognosis for tumors measuring 2 cm or smaller. Furthermore, in multivariate analysis, when the stage was analyzed with other prognostic factors determined in univariate analysis (cirrhosis of viral origin, multiple nodules, and microscopic vascular invasion), stage was the only independent predictor of prognosis. …
