Tumor Diameter for Hepatocellular Carcinoma: Why Should Size Matter?
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Tumor Diameter for Hepatocellular Carcinoma: Why Should Size Matter? Sertac Usta 1
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Cuneyt Kayaalp 1
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# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose There are two main goals in hepatocellular carcinoma management, the first is long term survival and the second is the low recurrence rate after the treatment. Therefore, a lot of selection criteria defined for each treatment method and tumor size is one of the most important parameter in almost all of them. Methods In this review, importance of diamater in hepatocellular carcinoma is reviewed. Results Many reports showed a significant association between increase in maximum tumor diameter and microvascular invasion. Patients with larger tumors are more likely to have poorly differentiated tumors. Increased regional and distant metastasis of tumors were observed in the larger size hepatocellular carcinoma. Liver transplantation represents the best treatment option for patients with decompensated liver cirrhosis and hepatocellular carcinoma. Conclusions Combined with biological, inflammatory, radiological, pathological and genetic markers that predict the biological behavior of the tumor, today, tumor size is one of the best aggressiveness markers until new markers are found. So, tumor size is matter. Keywords Tumor size . Tumor diameter . Hepatocellular carcinoma
Introduction Hepatocellular carcinoma (HCC) is the sixth most common cancer with 841,080 new cases in a year and the third most common cause of cancer-related deaths with 781,631 deaths worldwide [1]. HCC treatment options range from less invasive, such as local ablative treatments to highly complex procedures such as liver transplantation (LT). There are two main goals in HCC management: the first is long-term survival and the second is the low recurrence rate after the treatment. Therefore, the patient who will benefit the most from the treatment should be selected while making the decision of the treatment method. There are multiple selection criteria defined for each treatment method, and tumor size is one of the most important parameters in almost all of them. In this manuscript, we reviewed the importance of tumor size on treatment modalities for HCC.
* Sertac Usta [email protected] Cuneyt Kayaalp [email protected] 1
Department of Surgery, Liver Transplantation Institute, Inonu University, 44315 Malatya, Turkey
Tumor Size: Microvascular Invasion and Differentiation The frequency of microvascular invasion and poorly differentiated tumors increased among patients who had both independent risk factors of tumor recurrence [2]. Pawlik et al. [3] reported that the high incidence of occult vascular invasion and advanced histologic grade in HCC larger than 5 cm. Many reports, similar to those of Pawlik et al., showed a significant association between the increase in maximum tumor diameter (MTD) and microvascular invasion (MVI) [4–8]. In a study with 270 patients with HCC who underwent liver transplant from our institute, similar outco
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