Journal of Hepatocellular Carcinoma (Apr 2024)

Macroscopic Characterization of Hepatocellular Carcinoma: An Underexploited Source of Prognostic Factors

  • Gonvers S,
  • Martins-Filho SN,
  • Hirayama A,
  • Calderaro J,
  • Phillips R,
  • Uldry E,
  • Demartines N,
  • Melloul E,
  • Park YN,
  • Paradis V,
  • Thung SN,
  • Alves V,
  • Sempoux C,
  • Labgaa I

Journal volume & issue
Vol. Volume 11
pp. 707 – 719

Abstract

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Stéphanie Gonvers,1,2 Sebastiao N Martins-Filho,3 André Hirayama,4 Julien Calderaro,5 Rebecca Phillips,3 Emilie Uldry,1,2 Nicolas Demartines,1,2 Emmanuel Melloul,1,2 Young Nyun Park,6 Valérie Paradis,7 Swan N Thung,8 Venancio Alves,4 Christine Sempoux,2,9 Ismail Labgaa1,2 1Department of Visceral Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland; 2Faculty of Biology & Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland; 3Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada; 4Department of Pathology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil; 5Department of Pathology, APHP, Henri Mondor University Hospital, Creteil, Val-de-Marne, France; 6Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; 7Department of Pathology, APHP, Beaujon University Hospital, Clichy, France; 8Department of Pathology, Molecular and Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 9Department of Pathology, Lausanne University Hospital (CHUV), Lausanne, SwitzerlandCorrespondence: Ismail Labgaa, Department of Visceral Surgery, University Hospital of Lausanne (CHUV), Rue du Bugnon 46, CH-1011, Lausanne, Switzerland, Tel +41 0 79 556 68 47, Email [email protected]: The macroscopic appearance of a tumor such as hepatocellular carcinoma (HCC) may be defined as its phenotype which is de facto dictated by its genotype. Therefore, macroscopic characteristics of HCC are unlikely random but rather reflect genomic traits of cancer, presumably acting as a valuable source of information that can be retrieved and exploited to infer prognosis. This review aims to provide a comprehensive overview of the available data on the prognostic value of macroscopic characterization in HCC. A total of 57 studies meeting eligible criteria were identified, including patients undergoing liver resection (LR; 47 studies, 83%) or liver transplant (LT; 9 studies, 16%). The following macroscopic variables were investigated: tumor size (n = 42 studies), number of nodules (n = 28), vascular invasion (n = 24), bile duct invasion (n = 6), growth pattern (n = 15), resection margin (n = 11), tumor location (n = 6), capsule (n = 2) and satellite (n = 1). Although the selected studies provided insightful data with notable prognostic performances, a lack of standardization and substantial gaps were noted in the report and the analysis of gross findings. This topic remains incompletely covered. While the available studies underscored the value of macroscopic variables in HCC prognostication, important lacks were also observed. Macroscopic characterization of HCC is likely an underexploited source of prognostic factors that must be actively explored by future multidisciplinary research. Keywords: liver cancer, HCC, prognostication, gross, survival, recurrence

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