05/20/2002 By David Ball
Transplantation and/or ablation might offer alternative treatments in patients least likely to benefit from resection for small hepatocellular cancers (HCCs).
Such patients can be identified before surgery by the severity of underlying liver disease and a score based on tumour grade, according to physicians in the International Cooperative Study Group on Hepatocellular Carcinoma.
A multi-institutional database identified 180 men and 69 women with small (5 cm in diameter or less) HCC who were treated by resection. Pathology slides and clinical data were reviewed for the whole cohort (median age 62 years).
Clinical factors assessed before surgery and correlated with survival were age, gender, preoperative a-fetoprotein level, hepatitis serology, number of tumours and Child-Pugh score.
Three pathological factors – hepatitis activity score, fibrosis score and Edmondson-Steiner tumour grade – were also assessed.
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