Clinicopathological Features and Metastatic Pattern of Hepatocellular Carcinoma: An Autopsy Study of 398 Patients

Pathobiology. 2016;83(6):301-7. doi: 10.1159/000446245. Epub 2016 Jun 18.

Abstract

Objectives: Analysis of a large local autopsy collective to gather epidemiological and histopathological data on hepatocellular carcinoma (HCC).

Methods: We examined a large dataset of 44,104 autopsies performed at the Institute of Pathology, Basel, Switzerland, including 2 autopsy collectives (1969-1983 and 1988-2012) to gather current data on HCC in the advanced stage. A total of 398 HCC were diagnosed, accounting for around 1% of all autopsies.

Results: As expected, most patients developing HCC had advanced stages of liver fibrosis or cirrhosis (F3/F4). However, in the more recent autopsy collective (1988-2012), our data also show an increase of HCC arising in livers without or with only mild to moderate fibrosis (F0-F2). Extrahepatic metastasis was found in 156 of 398 HCC (39.1%), with lung metastasis (74.5%) being the most common, followed by the bones (24.8%) and adrenal glands (19.1%).

Conclusions: Our data therefore seem to suggest that, in the last 2 decades, despite the introduction of new therapeutic modalities for HCC, no significant changes have been observed regarding the metastatic pattern of advanced HCC.

MeSH terms

  • Adrenal Gland Neoplasms / secondary
  • Aged
  • Aged, 80 and over
  • Autopsy
  • Bone Neoplasms / secondary
  • Carcinoma, Hepatocellular / complications*
  • Carcinoma, Hepatocellular / epidemiology
  • Carcinoma, Hepatocellular / secondary*
  • Female
  • Humans
  • Liver / pathology
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / epidemiology
  • Liver Neoplasms / complications*
  • Liver Neoplasms / epidemiology
  • Liver Neoplasms / pathology
  • Lung Neoplasms / complications
  • Lung Neoplasms / epidemiology
  • Lung Neoplasms / secondary*
  • Male
  • Middle Aged
  • Switzerland / epidemiology