You are here

Plain English summary of "Prognostic Factors in Fibrolamellar Hepatocellular Carcinoma in Young People"

Published in Journal of Pediatric Surgery, January 2015

In this study, doctors performed an analysis of all fibrolamellar patients at a New York hospital (Memorial Sloan Keettering) between 1981 and 2011 to identify the best predictors of good and poor prognosis. Twenty-five patients were recorded at the hospital over that 30 year period. The most common presenting symptom was pain (present in 72% of patients) followed by the presence of an abdominal mass (44% of patients) and nausea (32% of patients). Using the American Joint Committee on Cancer staging proceedure, 5/25 patients were diagnosed at stage I, 1/25 at stage II, 1/25 at stage III and 18/25 at stage IV. Of these 18, 11 had stage IVA and 7 had stage IVB cancer. This means that the vast majority of patients had advanced disease by the time they were diagnosed, with the cancer having spread to nearby lymph nodes (stage IVA) or other parts of the body (stage IVB). The 5-year survival rate for patients was 42.6%, and average age at diagnosis was 17.1 years. 21/24 patients underwent a liver resection, and 17 of those patients had a complete resection while the rest had partial resections. The 5-year survival rate was higher for patients who underwent resections (51.6%) than for the whole patient group. The best predictors of positive outcomes were negative tumor margins during resection (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. On the other hand, if the cancer had spread to other organs (metastasis) or to lymph nodes, that was associated with worse prognosis and lower survival.

--Joseph Levin, Rockefeller University