Better survival in female patients with hepatocellular carcinoma. Possible causes from a pathologic approach
✍ Scribed by Irene O. L. Ng; Matthew M. T. Ng; Edward C. S. Lai; Sheung T. Fan
- Publisher
- John Wiley and Sons
- Year
- 1995
- Tongue
- English
- Weight
- 475 KB
- Volume
- 75
- Category
- Article
- ISSN
- 0008-543X
No coin nor oath required. For personal study only.
✦ Synopsis
Background. Hepatocellular carcinoma is notably more prevalent in men than in women.
Methods. To examine the sex-related characteristics of patients with primary hepatocellular carcinoma, 35 women were compared with 243 men, both groups having undergone surgical resection of the tumor.
Results. Women had a lower incidence of tumor recurrence, with median disease free survival of 19.5 months compared with 4.5 months for men (P < 0.001). Women also had more favorable actuarial survival than men [36.5 months for women compared with 12.4 months for men (P = 0.002)]. Women had a significantly higher incidence (80%) of tumor encapsulation than men (45%) ( P < 0.001). Furthermore, the tumors in women were frequently less invasive in terms of lower incidence of tumor microsatellites, liver invasion, and positive histologic margin. Tumor microsatellite formation was present with 16% of tumors in women, compared with 60% for men (P < 0.0001). Liver invasion was found in 37% of tumors in women and 61% in men (P = 0.03). Only 6% of tumors in women had a positive histologic margin, compared to 24% in men (P = 0.04). There was no statistical significance in the incidence of cirrhosis in'the nontumorous liver, hepatitis B surface antigen positivity, mean age, or tumor size, between women and men.
Conclusions. Women who had hepatocellular carcinoma and hepatic resection had better survival rates and a lower rate of tumor recurrence than male patients. The better prognosis in women with hepatocellular carcinoma appeared to be related to the pathobiologic characteristics of the tumor (i-e., frequent encapsulation and lower tumor invasiveness). Cancer 1995; 75:18-22.