Prognostic value of the proportion of the sclerosing component in fibrolamellar liver carcinoma

Introduction. Fibrolamellar hepatocellular carcinoma (FLC), which develops most often in the younger population. In FLC, variable histoarchitectonics are noted, possibly the presence of a sclerosing component, foci of necrosis and dystrophy of tumor cells.Objective. Assessment of the influence of th...

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Main Authors: E. Yu. Antonova, E. A. Moroz, D. V. Podluzhny, N. E. Kudashkin, I. A. Dzhanyan, A. Yu. Volkov, K. K. Laktionov, V. V. Breder
Format: Article
Language:Russian
Published: Remedium Group LLC 2021-12-01
Series:Медицинский совет
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Online Access:https://www.med-sovet.pro/jour/article/view/6585
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author E. Yu. Antonova
E. A. Moroz
D. V. Podluzhny
N. E. Kudashkin
I. A. Dzhanyan
A. Yu. Volkov
K. K. Laktionov
V. V. Breder
author_facet E. Yu. Antonova
E. A. Moroz
D. V. Podluzhny
N. E. Kudashkin
I. A. Dzhanyan
A. Yu. Volkov
K. K. Laktionov
V. V. Breder
author_sort E. Yu. Antonova
collection DOAJ
description Introduction. Fibrolamellar hepatocellular carcinoma (FLC), which develops most often in the younger population. In FLC, variable histoarchitectonics are noted, possibly the presence of a sclerosing component, foci of necrosis and dystrophy of tumor cells.Objective. Assessment of the influence of the proportion of the sclerosing component in fibrolamellar carcinoma (FLC) of the liver on the course and prognosis of the disease. Determination of the relationship between the proportion of the sclerosing component in the tumor and the frequency of microvascular invasion.Materials and methods. A retrospective study included 34 patients with a diagnosis of FLC, who underwent radical surgical treatment at the first stage. A histological assessment of the proportion (%) of the sclerosing component in FLC was made. The effect of  the  proportion of  the  sclerosing component on overall (OS) and relapse-free (DFS) survival was assessed. The  analysis of the relationship between the proportion of the sclerosing component in the tumor and the frequency of microvascular invasion was carried out.Results. Significantly worse RFS was achieved in the groups of patients with a sclerosing component in FLC > 5% than in the group of patients with a sclerosing component in FLC ≤ 5% (p = 0.0010; p = 0.024; log – rank test). Median DDS in group 1 is 107 (95% CI, 22–192) months; at 2 – 11 (95% CI, 8–14) months; in 3 – 21 (95% CI, 8–33). The frequency of histologically confirmed microvascular invasion in the compared groups was 29, 74, 87.5%, respectively. OS was significantly worse in 2 groups (27 patients in total) with a sclerosing component in FLC > 5% than in the group of patients with a sclerosing component in FLC ≤ 5%. Median OS in group 1 120 (95% CI, 60–180) months; at 2 – 41 (95% CI, 15–92) months; in 3 – 69 (95% CI, 35–103). A direct relationship was found between an increase in the proportion of the sclerosing component in a tumor and an increase in the frequency of microvascular invasion.Conclusions. We can assume that the severity of the sclerosing component in the FLK tumor can serve as an effective morphological marker of a less favorable prognosis for this HCC subtype and correlate with the frequency of microvascular invasion.
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spelling doaj.art-0fb253b580fd402d89fd7f26341a74652023-04-23T06:57:11ZrusRemedium Group LLCМедицинский совет2079-701X2658-57902021-12-010209410010.21518/2079-701X-2021-20-94-1005946Prognostic value of the proportion of the sclerosing component in fibrolamellar liver carcinomaE. Yu. Antonova0E. A. Moroz1D. V. Podluzhny2N. E. Kudashkin3I. A. Dzhanyan4A. Yu. Volkov5K. K. Laktionov6V. V. Breder7Blokhin National Medical Research Center of OncologyBlokhin National Medical Research Center of OncologyBlokhin National Medical Research Center of OncologyBlokhin National Medical Research Center of OncologyBlokhin National Medical Research Center of OncologyPletnev City Clinical HospitalPirogov Russian National Research Medical UniversityBlokhin National Medical Research Center of OncologyIntroduction. Fibrolamellar hepatocellular carcinoma (FLC), which develops most often in the younger population. In FLC, variable histoarchitectonics are noted, possibly the presence of a sclerosing component, foci of necrosis and dystrophy of tumor cells.Objective. Assessment of the influence of the proportion of the sclerosing component in fibrolamellar carcinoma (FLC) of the liver on the course and prognosis of the disease. Determination of the relationship between the proportion of the sclerosing component in the tumor and the frequency of microvascular invasion.Materials and methods. A retrospective study included 34 patients with a diagnosis of FLC, who underwent radical surgical treatment at the first stage. A histological assessment of the proportion (%) of the sclerosing component in FLC was made. The effect of  the  proportion of  the  sclerosing component on overall (OS) and relapse-free (DFS) survival was assessed. The  analysis of the relationship between the proportion of the sclerosing component in the tumor and the frequency of microvascular invasion was carried out.Results. Significantly worse RFS was achieved in the groups of patients with a sclerosing component in FLC > 5% than in the group of patients with a sclerosing component in FLC ≤ 5% (p = 0.0010; p = 0.024; log – rank test). Median DDS in group 1 is 107 (95% CI, 22–192) months; at 2 – 11 (95% CI, 8–14) months; in 3 – 21 (95% CI, 8–33). The frequency of histologically confirmed microvascular invasion in the compared groups was 29, 74, 87.5%, respectively. OS was significantly worse in 2 groups (27 patients in total) with a sclerosing component in FLC > 5% than in the group of patients with a sclerosing component in FLC ≤ 5%. Median OS in group 1 120 (95% CI, 60–180) months; at 2 – 41 (95% CI, 15–92) months; in 3 – 69 (95% CI, 35–103). A direct relationship was found between an increase in the proportion of the sclerosing component in a tumor and an increase in the frequency of microvascular invasion.Conclusions. We can assume that the severity of the sclerosing component in the FLK tumor can serve as an effective morphological marker of a less favorable prognosis for this HCC subtype and correlate with the frequency of microvascular invasion.https://www.med-sovet.pro/jour/article/view/6585fibrolamellar carcinomaliver tumorprognosissclerosing componentmicrovascular invasion
spellingShingle E. Yu. Antonova
E. A. Moroz
D. V. Podluzhny
N. E. Kudashkin
I. A. Dzhanyan
A. Yu. Volkov
K. K. Laktionov
V. V. Breder
Prognostic value of the proportion of the sclerosing component in fibrolamellar liver carcinoma
Медицинский совет
fibrolamellar carcinoma
liver tumor
prognosis
sclerosing component
microvascular invasion
title Prognostic value of the proportion of the sclerosing component in fibrolamellar liver carcinoma
title_full Prognostic value of the proportion of the sclerosing component in fibrolamellar liver carcinoma
title_fullStr Prognostic value of the proportion of the sclerosing component in fibrolamellar liver carcinoma
title_full_unstemmed Prognostic value of the proportion of the sclerosing component in fibrolamellar liver carcinoma
title_short Prognostic value of the proportion of the sclerosing component in fibrolamellar liver carcinoma
title_sort prognostic value of the proportion of the sclerosing component in fibrolamellar liver carcinoma
topic fibrolamellar carcinoma
liver tumor
prognosis
sclerosing component
microvascular invasion
url https://www.med-sovet.pro/jour/article/view/6585
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