Document Detail


Pre-operative liver biopsy in cirrhotic patients with early hepatocellular carcinoma represents a safe and accurate diagnostic tool for tumour grading assessment.
MedLine Citation:
PMID:  21056498     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Knowledge of pre-operative tumour grade is crucial in the management of hepatocellular carcinoma (HCC) because it can influence recurrence and survival after surgery. The accuracy of pre-operative needle core biopsy (NCB) in tumour grading has been assessed in only a few studies with conflicting results. Our aim was to determine the long-term safety and the overall accuracy of NCB in assessing tumour grading in subjects who had undergone liver resection for a single HCC.
METHODS: Eighty-one cirrhotic patients with HCC who had undergone NCB before liver resection were selected. Only patients with a single HCC and with at least a five-year-follow-up were included. Tumour grading was scored according to a modified Edmondson-Steiner classification: well/moderately (low grade) vs poorly-differentiated (high grade).
RESULTS: In the 81 patients with a solitary HCC (mean size 4.1 ± 2.3cm) tumour grade was correctly identified by NCB in 74 out of 81 (91.4%) HCCs. NCB overall sensitivity and specificity were 65% and 98.1%, respectively, with a PPV of 92% and an NPV of 91%. No major complications (in particular tumour seeding) were observed. The overall survival rates at 1, 3, and 5 years were 83%, 62%, and 44%, respectively; the recurrence rate after a 5-year-follow-up was 56.2% for low grade and 82.3% for high grade tumours (p<0.007).
CONCLUSIONS: Pre-operative NCB can be performed on early (<5 cm) HCC cirrhotic patients because it provides histologically useful information for HCC management with good accuracy and a low complication rate.
Authors:
Antonio Colecchia; Eleonora Scaioli; Lucia Montrone; Amanda Vestito; Anna Rita Di Biase; Martina Pieri; Antonia D'Errico-Grigioni; Maria Letizia Bacchi-Reggiani; Matteo Ravaioli; Gian Luca Grazi; Davide Festi
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Publication Detail:
Type:  Journal Article     Date:  2010-09-07
Journal Detail:
Title:  Journal of hepatology     Volume:  54     ISSN:  1600-0641     ISO Abbreviation:  J. Hepatol.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-18     Completed Date:  2011-04-25     Revised Date:  2012-08-24    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  300-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Affiliation:
Department of Clinical Medicine, University of Bologna, Italy. antonio.colecchia@aosp.bo.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Biopsy, Needle / methods*
Carcinoma, Hepatocellular / pathology*,  surgery
Female
Follow-Up Studies
Humans
Liver / pathology*
Liver Cirrhosis / pathology*
Liver Neoplasms / pathology*,  surgery
Male
Middle Aged
Neoplasm Staging

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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