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. 2013;85(4):197-203.
doi: 10.1159/000354698. Epub 2013 Sep 19.

Prognostic indicators and treatment outcome in 94 cases of fibrolamellar hepatocellular carcinoma

Ahmed O Kaseb  1 , Mohamed Shama, Ibrahim Halil Sahin, Ajay Nooka, Hesham M Hassabo, Jean-Nicolas Vauthey, Thomas Aloia, James L Abbruzzese, Ishwaria M Subbiah, Filip Janku, Steven Curley, Manal M Hassan
Affiliations

Prognostic indicators and treatment outcome in 94 cases of fibrolamellar hepatocellular carcinoma

Ahmed O Kaseb et al. Oncology. 2013.

Abstract

Objective: Fibrolamellar hepatocellular carcinoma (FLHCC) is a rare variant of HCC. We report an analysis of the clinicopathologic features, treatment outcomes, and prognostic indicators of 94 cases.

Methods: We retrospectively collected clinicopathologic and treatment outcome data from 94 FLHCC patients (48 males and 46 females). Median overall survival (OS) and recurrence-free survival (RFS) were calculated using Kaplan-Meier curves, and survival rates were compared by the log-rank test. The Cox proportional hazard model was used for univariate and multivariate estimation of hazard risk ratios and 95% confidence intervals (CI) for factors that correlated with survival and disease recurrence after resection.

Results: Median age was 23 years (14-75); median OS was 57.2 months (95% CI, 36.4-77.9), and median RFS was 13.9 months (95% CI, 8.8-18.9). White race, female gender, early tumor stage, and tumor resection including metastasectomy were positively associated with longer OS, while female gender was the only significant positive predictor of longer RFS. Finally, the 5-fluorouracil-interferon combination was the most frequently used systemic therapy.

Conclusions: Our analyses indicate that surgical approaches including metastasectomy as the first-line treatment in FLHCC correlated with better outcome. Multimodality approaches, including neoadjuvant and adjuvant therapies, prolonged patient survival.

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Conflict of interest statement

Disclosures: We have no commercial associations (e.g., consultancies, stock ownership, equity interests, or patent-licensing arrangements) that might pose a conflict of interest in connection with the submitted article.

Figures

Figure 1A
Figure 1A
Kaplan-Meier overall survival estimate curve for all patients (N=94). Abbreviations: N, number of patients; CI, confidence interval; m, months.
Figure 1B
Figure 1B. Kaplan-Meier overall survival estimate curve for patients based on treatment modality received
Abbreviations: N, number of patients; CI, confidence interval; m, months.
See this image and copyright information in PMC

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