Which factors are associated with poor prognosis of hepatocellular carcinoma (HCC)?

Updated: Jan 31, 2021
  • Author: Luca Cicalese, MD, FACS; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Answer

In addition to tumor burden, survival after transplantation has also been correlated with a variety of anatomic and pathologic features. Poor prognosis has been associated with the following [52, 86, 87] :

  • Bilobar distribution of tumor
  • Vascular invasion (particularly macroscopic tumor invasion)
  • Higher histologic grade
  • Pretreatment AFP level higher than 300 ng/mL

In these patients, tumor recurrence is highly likely. Whereas fibrolamellar histology has been associated with improved prognosis following resection, posttransplant survival appears to be equivalent to hepatocellular carcinoma in general. Finally, clinically evident reinfection with hepatitis B virus (HBV) or hepatitis C virus (HCV) has been correlated with tumor recurrence. In patients with hepatitis C, active viral recurrence is associated with a 40% risk of tumor development in the transplanted organ. [88]


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