Hepatocellular carcinoma in Taiwan: clinicopathological study of 440 cases from a consecutive 6000 autopsies

The clinico-pathological features of 440 autopsy cases of hepatocellular carcinoma collected in a 30-year period were analyzed. The statistical observations included sex, age, clinical presentations, initial symptoms and signs, physical findings, varices, ascites, alpha-fetoprotein, serum hepatitis B surface antigen, liver weight, gross anatomic and histologic features of the tumors, grade of anaplasia, changes in noncancer parenchyma, and survival. Multivariate analyses demonstrated that age, HBsAg, AFP, associated cirrhosis, liver weight, gross pathology, histologic grading and structural pattern, and presence of clear cells did not correlate to the prognosis. The presence of metastasis adversely influenced the outcome. Bile production was associated with better tumor differentiation and longer patient survival. It also found that the smaller tumor tended to be more well differentiated.