We use cookies to improve your experience. By continuing to browse this site, you accept our cookie policy.×
Skip main navigation
Aging Health
Bioelectronics in Medicine
Biomarkers in Medicine
Breast Cancer Management
CNS Oncology
Colorectal Cancer
Concussion
Epigenomics
Future Cardiology
Future Medicine AI
Future Microbiology
Future Neurology
Future Oncology
Future Rare Diseases
Future Virology
Hepatic Oncology
HIV Therapy
Immunotherapy
International Journal of Endocrine Oncology
International Journal of Hematologic Oncology
Journal of 3D Printing in Medicine
Lung Cancer Management
Melanoma Management
Nanomedicine
Neurodegenerative Disease Management
Pain Management
Pediatric Health
Personalized Medicine
Pharmacogenomics
Regenerative Medicine

Influence of clear cell carcinoma on the post-hepatectomy prognosis of patients with hepatocellular carcinoma

    Yongheng Deng‡

    Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, China

    ‡Authors contributed equally

    Search for more papers by this author

    ,
    Shaoliang Zhu‡

    Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, China

    ‡Authors contributed equally

    Search for more papers by this author

    ,
    Wen Yan‡

    Clinical School of Medicine, Jiamusi University, China

    ‡Authors contributed equally

    Search for more papers by this author

    ,
    Lunan Qi

    Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, China

    ,
    Zushun Chen

    *Author for correspondence: Tel.: +86 077 1533 1955;

    E-mail Address: qiyk225@163.com

    Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, China

    &
    Liang Ma

    **Author for correspondence: Tel.: +86 077 1533 1955;

    E-mail Address: malianggxyd@163.com

    Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, China

    Published Online:https://doi.org/10.2217/fon-2021-0381

    Aim: The authors aimed to identify factors that independently influence the survival of patients with primary clear cell carcinoma of the liver (PCCCL). Methods: A total of 470 patients with hepatocellular carcinoma were retrospectively analyzed. Multivariate Cox analysis was used to identify potential factors associated with prognosis of PCCCL. Results: Patients with PCCCL showed significantly higher disease-free survival (DFS) and overall survival (OS) compared with patients with non-clear cell hepatocellular carcinoma. Multivariate analysis revealed that AFP level, tumor size, liver cirrhosis and portal vein tumor thrombosis were risk factors for DFS. Tumor size, capsule formation and Ki-67 were risk factors for OS. Satellite nodules acted as a protective factor for DFS and OS. Conclusion: PCCCL is associated with better prognosis in hepatocellular carcinoma. Tumor size and satellite nodules may be independent predictors of OS and DFS.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

    References

    • 1. Ferlay J, Soerjomataram I, Dikshit R et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int. J. Cancer 136(5), e359–e386 (2015).
    • 2. Lai C, Wu P, Lam K, Todd D. Histologic prognostic indicators in hepatocellular carcinoma. Cancer 44(5), 1677–1683 (1979). •• First observational study reporting better long-term prognosis of primary clear cell carcinoma of the liver (PCCCL) compared with other histological types of hepatocellular carcinoma (HCC).
    • 3. Emile JF, Lemoine A, Azoulay D, Debuire B, Bismuth H, Reynes M. Histological, genomic and clinical heterogeneity of clear cell hepatocellular carcinoma. Histopathology 38(3), 225–231 (2001).
    • 4. Yang SH, Watanabe J, Nakashima O, Kojiro M. Clinicopathologic study on clear cell hepatocellular carcinoma. Pathol. Int. 46(7), 503–509 (1996).
    • 5. Buchanan TF Jr, Huvos AG. Clear-cell carcinoma of the liver: a clinicopathologic study of 13 patients. Am. J. Clin. Pathol. 61(4), 529–539 (1974).
    • 6. Liu Z, Ma W, Li H, Li Q. Clinicopathological and prognostic features of primary clear cell carcinoma of the liver. Hepatol. Res. 38(3), 291–299 (2008). • Found that PCCCL showed superior prognosis compared with other histological types and revealed the associated risk factors of early and late intrahepatic recurrence.
    • 7. Adamek HE, Spiethoff A, Kaufmann V, Jakobs R, Riemann JF. Primary clear cell carcinoma of noncirrhotic liver: immunohistochemical discrimination of hepatocellular and cholangiocellular origin. Dig. Dis. Sci. 43(1), 33 (1998).
    • 8. Ji S-P, Li Q, Dong H. Therapy and prognostic features of primary clear cell carcinoma of the liver. World J. Gastroenterol. 16(6), 764 (2010).
    • 9. Edmondson HA. Tumors of the liver and intrahepatic bile ducts. In: Atlas of Tumor Pathology. Armed Forces Institute of Pathology, US (1958).
    • 10. Li T, Fan J, Qin L-X et al. Risk factors, prognosis, and management of early and late intrahepatic recurrence after resection of primary clear cell carcinoma of the liver. Ann. Surg. Oncol. 18(7), 1955–1963 (2011).
    • 11. Chen Z-S, Zhu S-L, Qi L-N, Li L-Q. Long-term survival and prognosis for primary clear cell carcinoma of the liver after hepatectomy. Onco Targets Ther. 9, 4129 (2016). •• Reports better long-term prognosis of PCCCL compared with other histological types of HCC.
    • 12. Mcdermott WV, Cady B, Georgi B, Steele G, Khettry U. Primary cancer of the liver: evaluation, treatment, and prognosis. Arch. Surg. 124(5), 552–555 (1989).
    • 13. Zhang Z, Xie H, Chen P, Cao P. Development and identification of a nomogram prognostic model for patients with primary clear cell carcinoma of the liver. Med. Sci. Monit. 26, e919789 (2020). • Develops and validates a nomogram to predict prognosis of PCCCL.
    • 14. Zhu S-L, Zhong J-H, Ke Y, Ma L, You X-M, Li L-Q. Efficacy of hepatic resection vs transarterial chemoembolization for solitary huge hepatocellular carcinoma. World J. Gastroenterol. 21(32), 9630 (2015).
    • 15. Belghiti J, Noun R, Malafosse R et al. Continuous versus intermittent portal triad clamping for liver resection: a controlled study. Ann. Surg. 229(3), 369 (1999).
    • 16. Xia Y, Yan Z-L, Xi T et al. A case-control study of correlation between preoperative serum AFP and recurrence of hepatocellular carcinoma after curative hepatectomy. Hepatogastroenterology 59(119), 2248–2254 (2012).
    • 17. Luo Y, Ren F, Liu Y et al. Clinicopathological and prognostic significance of high Ki-67 labeling index in hepatocellular carcinoma patients: a meta-analysis. Int. J. Clin. Exp. Med. 8(7), 10235 (2015).
    • 18. Park SK, Jung YK, Chung DH et al. Factors influencing hepatocellular carcinoma prognosis after hepatectomy: a single-center experience. Korean J. Intern. Med. 28(4), 428 (2013).
    • 19. Wada H, Eguchi H, Nagano H et al. Perioperative allogenic blood transfusion is a poor prognostic factor after hepatocellular carcinoma surgery: a multi-center analysis. Surg. Today 48(1), 73–79 (2018).
    • 20. Zhou L, Rui J-A, Wang S-B et al. Outcomes and prognostic factors of cirrhotic patients with hepatocellular carcinoma after radical major hepatectomy. World J. Surg. 31(9), 1782–1787 (2007).
    • 21. Shi C, Zhao Q, Liao B et al. Anatomic resection and wide resection margin play an important role in hepatectomy for hepatocellular carcinoma with peritumoural micrometastasis. ANZ J. Surg. 89(11), e482–e486 (2019).
    • 22. Zhang X, Li J, Shen F, Lau WY. Significance of presence of microvascular invasion in specimens obtained after surgical treatment of hepatocellular carcinoma. J. Gastroenterol. Hepatol. 33(2), 347–354 (2018).
    • 23. Liu Q-Y, Li H-G, Gao M, Lin X-F, Li Y, Chen J-Y. Primary clear cell carcinoma in the liver: CT and MRI findings. World J. Gastroenterol. 17(7), 946 (2011).
    • 24. Steffens S, Janssen M, Roos FC et al. Incidence and long-term prognosis of papillary compared to clear cell renal cell carcinoma–a multicentre study. Eur. J. Cancer 48(15), 2347–2352 (2012).
    • 25. Sugiyama T, Kamura T, Kigawa J et al. Clinical characteristics of clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy. Cancer 88(11), 2584–2589 (2000).
    • 26. Chen M-F, Hwang T-L, Jeng L-B, Wang C-S, Jan Y-Y, Chen S-C. Postoperative recurrence of hepatocellular carcinoma: two hundred five consecutive patients who underwent hepatic resection in 15 years. Arch. Surg. 129(7), 738–742 (1994).
    • 27. Fuster J, García-Valdecasas JC, Grande L et al. Hepatocellular carcinoma and cirrhosis. Results of surgical treatment in a European series. Ann. Surg. 223(3), 297 (1996).
    • 28. Poon RTP, Fan ST, Ng IOL, Lo CM, Liu CL, Wong J. Different risk factors and prognosis for early and late intrahepatic recurrence after resection of hepatocellular carcinoma. Cancer 89(3), 500–507 (2000).
    • 29. Dai X, Xue J, Hu J et al. Positive expression of programmed death ligand 1 in peritumoral liver tissue is associated with poor survival after curative resection of hepatocellular carcinoma. Transl. Oncol. 10(4), 511–517 (2017).
    • 30. Dai T, Peng L, Lin G et al. Preoperative elevated plasma fibrinogen level predicts tumor recurrence and poor prognosis in patients with hepatocellular carcinoma. J. Gastrointest. Oncol. 10(6), 1049 (2019).
    • 31. Zhong F-P, Zhang Y-J, Liu Y, Zou S-B. Prognostic impact of surgical margin in patients with hepatocellular carcinoma: a meta-analysis. Medicine (Baltimore) 96(37), e8043 (2017).