CLINICOPATHOLOGICAL STUDY OF MULTINODULAR HEPATOCELLULAR CARCINOMA-MACROSCOPIC STAGING AND CURABILITY-

Clinicopathological study of multicentric emergence, macroscopic staging and curability was made in 13 cases of multinodular hepatocellular carcinoma (HCC) among 68 resected cases of HCC smaller than 5cm in diameter. Macroscopic staging of 55 cases of solitary HCC showed 10 in Stage I, 24 in Stage II and 21 in Stage III, while 13 cases of multinodular HCC included one in Stage II, 6 in Stage III and 6 in Stage IV-A. Moreover, curability classification of solitary cases turned out absolute curative resection (AC) in 6 cases, relative curative resection (RC) in 37 and relative non-curative resection (RNC) in 12, while, of multinodular cases, 3 obtained RC and 10 obtained RNC. On the other hand, 10 of 13 multinodular cases were considered to have multicentric HCC and the 5-year survival rate was 54%. In solitary cases, the 5-year survival rates were 36% overall, 80%, 52%, 15% for Stage I, II and III, and 100%, 43%, 22% for AC, RC and RNC, respectively. Thus, compared with solitary HCC, there were more cases of progressive stages and/or RNC in multinodular HCC, whereas a relatively good prognosis was obtained in multicentric HCC. These findings suggest that the stage and curability classification should be investigated, entertaining a possible occurrence of multicentric HCC.