Characteristic differences of hepatocellular carcinoma in Japan, with special reference to liver weight at autopsy

Liver weight at autopsy in patients with hepatocellular carcinoma (HCC) has been found to differ by geographic region. The clinicopathological characteristics of HCC in relation to liver weight at autopsy have not been reported for Japanese cases.

From 1980 to 1992, a total of 107 consecutive HCC autopsy cases were studied. Seven cases were excluded (5 surgically resected cases and 2 cases of occult-type HCC (Berman) which were diagnosed at autopsy for the first time). The 100 cases of HCC were divided into 4 groups according to liver weight at autopsy: less than 999 g (group A, n = 15, 15%); 1000-1999 g (group B, n = 50, 50%); 2,000-2,999 g (group C, n = 20, 20%); and more than 3,000 g (group D, n = 15, 15%). Various clinical and pathological findings, including age, sex, hepatitis B surface antigen (HBsAg) status, history of blood transfusions, treatment, cause of death, underlying liver disease, survival after diagnosis, tumor size, macroscopic findings, microscopic findings, splenic weight and liver weight were studied.

Significant differences between groups were found in sex (p < 0.01), underlying liver disease (p < 0.001), tumor size (p < 0.0001), microscopic findings (p < 0.001) and survival (p < 0.01). The lowest liver weight group (group A) had a significantly longer mean survival rate than the other three groups (p < 0.001).

These results showed that 15% of HCC occurred in large size livers (more than 3,000 g), 15% occurred in small size livers (less than 999 g) and 70% occurred in livers between 1,000 g and 2,999 g, and that tumor size (p < 0.0001) and microscopic findings (p < 0.001) were the major determinants of liver weight in HCC patients. The total liver volume reflected by liver weight in HCC cases may be valuable for the assessment of the clinicopathological features of HCC and its prognosis.