Scirrhous Hepatocellular Carcinoma: Systematic Review & Pooled Data Analysis of Clinical, Radiolo...

LIVER SURGERY RESEARCH HEIDELBERG

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Scirrhous Hepatocellular Carcinoma: Systematic Review and Pooled Data Analysis of Clinical, Radiological, and Histopathological Features

Oct. 22, 2021

HEIDELBERG, GERMANY – On Oct. 22, 2021, Liver Surgery Research Heidelberg’s new research, “Scirrhous Hepatocellular Carcinoma: Systematic Review and Pooled Data Analysis of Clinical, Radiological, and Histopathological Features,” authored by Anastasia Murtha-Lemekhova, Juri Fuchs, Erik Schulz, Anthe Sterkenburg, Philipp Mayer, Jan Pfeiffenberger, and Katrin Hoffmann, was published by the Journal of Hepatocellular Carcinoma.

Background: Aberrant subtypes of hepatocellular carcinoma (HCC) account for 20-30% of all HCCs and habitually present a challenge in diagnosis and treatment. Scirrhous hepatocellular carcinoma (s-HCC) is often misdiagnosed as cholangiocarcinoma, fibrolamellar hepatocellular carcinoma, or metastasis.

Methods: Electronic databases (PubMed, Web of Knowledge, Google Scholar, Cochrane Library, and WHO International Clinical Trials Registry Platform) were searched for publications on scirrhous hepatocellular carcinoma without date or language restrictions. Quality assessment was performed using a tool proposed by Murad et al for case reports and series. For observational studies, MINORS quality assessment tool was used. This study was registered at PROSPERO (CRD42020212323).

Results: S-HCC arises in patients with chronic hepatitis (hepatitis B in 60% and hepatitis C in 21%). S-HCC primarily affects men with a mean age of 55.8 years. Serum AFP is elevated above 20IU/mL in 66.7% of the patients. On ultrasound, s-HCC presents as hypoechoic or mosaic pattern lesions (47.6% each) and causes a retraction of the liver surface (70%) when near the capsule. Delayed enhancement of the tumor is evident in 87.0%. On MRI, 65.0% of s-HCCs show a target appearance. Histopathologic pattern is mostly irregular (97.6%). Lesions show a bulging appearance (100%), septae (85.6%) and a central scar (63.5%), and usually lack central necrosis (75%). Immunohistochemistry shows HepPar 1 positivity in 64.6%, CK7 in 40.7%, and EMA in 41.9%. The 5-year overall survival rate estimates 45.2% and 45.5% of the patients experience a recurrence after hepatectomy.

Conclusion: S-HCC is a rare subtype of HCC primarily arising in hepatitis- or cirrhosis-afflicted livers and incorporates atypical radiological and histopathological HCC features. Despite lower recurrence rates, overall survival of patients with s-HCC is poorer than generally for HCC, underlining the need for individualized treatment. Patients with atypical lesions of the liver should be referred to tertiary hospitals for interdisciplinary assessment and treatment. To learn more about this study, visit https://doi.org/10.2147/JHC.S328198.

About Liver Surgery Research HD

Liver Surgery Research Heidelberg (LSRHD) is a research group, located at Heidelberg University in Heidelberg - Germany, that specializes in research investigating liver regeneration after hepatectomy (liver resection) and post-hepatectomy liver failure, HCC development and treatment (especially in the context of MAFLD [metabolically associated fatty liver disease]), and rare liver lesions and diseases. LSRHD is the founder and leader of the RELIVE (RarE LIVEr) Initiative; a multidisciplinary project to establish evidence-based therapies for rare liver diseases. LSRHD is currently working on over 20 research projects and has over 100 peer reviewed published authorships. To learn more about LSRHD, visit www.liversurgeryresearch.com.

Contact:

Nicholas Murtha

Communications Manager

Liver Surgery Research Heidelberg

liversurgeryresearch@protonmail.com

nicholas.murtha@protonmail.com

Reference:

Murtha-Lemekhova, A., Fuchs, J., Schulz, E., Sterkenburg, A. S., Mayer, P., Pfeiffenberger, J., & Hoffmann, K. (2021). Scirrhous Hepatocellular Carcinoma: Systematic Review and Pooled Data Analysis of Clinical, Radiological, and Histopathological Features. Journal of hepatocellular carcinoma, 8, 1269–1279. https://doi.org/10.2147/JHC.S328198

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