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Plain English summary of Clinical and pathological evaluation of fibrolamellar hepatocellular carcinoma: a single center study of 21 cases

Published in Clinics, March, 2015

In this study, doctors analysed 21 fibrolamellar patients at a Sao Paulo hospital to identify the best predictors of good and poor prognosis. Two-thirds of the patients were female, and the average age at diagnosis was 20 years old. Fifteen out of 21 patients had stage III or IV cancer at the time of diagnosis, which means the cancer had grown extensively in the liver and spread to nearby lymph nodes or distant organs by the time of diagnosis. Three out of 21 patients had "mixed/ fibrolamellar," which means the tumor contained regions which looked like conventional hepatocellular carcinoma as well as regions which looked like fibrolamellar. The authors found  "mixed" fibrolamellar had a worse prognosis. Twenty out of 21 patients had surgery, but in six of these cases the tumor was considered inoperable. Surgery was the best option to treat the disease. Recurrence occurred in 8/10 patients who had follow-ups, with the average time to recurrence being 12 months. If the tumor was at a more advanced stage at the time of surgery the patient was more likely to experience recurrence.

The best predictors of a good prognosis were negative surgical margins (which means that during surgery no cancer cells were seen at the edge of the tissue that was removed) and an earlier stage of disease at diagnosis and treatment with less invasion of surrounding lymph nodes and organs.