Diffuse infiltrative hepatocellular carcinoma: Assessment of presentation, treatment, and outcomes

Peter J. Kneuertz, Aram Demirjian, Amin Firoozmand, Celia Corona Villalobos, Nikhil Bhagat, Joseph Herman, Andrew M Cameron, Ahmet Gurakar, David Cosgrove, Michael A. Choti, Jean Francois H Geschwind, Ihab R Kamel, Timothy M. Pawlik

Research output: Contribution to journalArticle

Abstract

Background: Data on infiltrating hepatocellular carcinoma (HCC) are limited. We sought to define treatment and outcome of patients treated with infiltrating HCC compared with patients who had advanced multifocal HCC. Methods: Between January 2000 and July 2011, a total of 147 patients with advanced HCC were identified from the Johns Hopkins Hospital database (infiltrative, n = 75; multifocal, n = 72). Clinicopathologic data were compared by HCC subtype. Results: Patients with infiltrating HCC had higher alfafetoprotein levels (median infiltrative, 326.5 ng/mL vs. multifocal, 27.0 ng/mL) and larger tumors (median size, infiltrating, 9.2 cm vs. multifocal, 5.5 cm) (P 400 ng/mL were associated with worse survival after IAT (P <0.05). Patients with progressive disease after IAT had higher risk of death versus patients who had stable/responsive disease (hazard ratio 3.53, 95 % confidence interval 1.49-8.37; P = 0.004). Conclusions: Patients with infiltrative HCC often present without a discrete lesion on imaging. IAT for infiltrative HCC was safe and was associated with survival comparable to IAT outcomes for patients with multifocal HCC. Infiltrative HCC morphology is not a contraindication to IAT therapy in select patients.

Original languageEnglish (US)
Pages (from-to)2897-2907
Number of pages11
JournalAnnals of Surgical Oncology
Volume19
Issue number9
DOIs
StatePublished - Sep 2012

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Hepatocellular Carcinoma
Survival
Databases
Confidence Intervals

ASJC Scopus subject areas

  • Surgery
  • Oncology

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Diffuse infiltrative hepatocellular carcinoma : Assessment of presentation, treatment, and outcomes. / Kneuertz, Peter J.; Demirjian, Aram; Firoozmand, Amin; Corona Villalobos, Celia; Bhagat, Nikhil; Herman, Joseph; Cameron, Andrew M; Gurakar, Ahmet; Cosgrove, David; Choti, Michael A.; Geschwind, Jean Francois H; Kamel, Ihab R; Pawlik, Timothy M.

In: Annals of Surgical Oncology, Vol. 19, No. 9, 09.2012, p. 2897-2907.

Research output: Contribution to journalArticle

Kneuertz, PJ, Demirjian, A, Firoozmand, A, Corona Villalobos, C, Bhagat, N, Herman, J, Cameron, AM, Gurakar, A, Cosgrove, D, Choti, MA, Geschwind, JFH, Kamel, IR & Pawlik, TM 2012, 'Diffuse infiltrative hepatocellular carcinoma: Assessment of presentation, treatment, and outcomes', Annals of Surgical Oncology, vol. 19, no. 9, pp. 2897-2907. https://doi.org/10.1245/s10434-012-2336-0
Kneuertz, Peter J. ; Demirjian, Aram ; Firoozmand, Amin ; Corona Villalobos, Celia ; Bhagat, Nikhil ; Herman, Joseph ; Cameron, Andrew M ; Gurakar, Ahmet ; Cosgrove, David ; Choti, Michael A. ; Geschwind, Jean Francois H ; Kamel, Ihab R ; Pawlik, Timothy M. / Diffuse infiltrative hepatocellular carcinoma : Assessment of presentation, treatment, and outcomes. In: Annals of Surgical Oncology. 2012 ; Vol. 19, No. 9. pp. 2897-2907.
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