Differences in Characteristics and Outcome After Hepatic Resection Among Various Types of Mass-Forming Primary Liver Cancer

Primary liver tumors vary in carcinogenesis. It is well known that these tumors have two carcinogenic pathways: small and large duct pathogenesis. Small duct pathogenesis is always present as mass-forming tumors. Large duct etiology tumors can be periductal infiltration or intraductal growth with mass-forming appearing in the late stage. Our objective is to analyze and compare the characteristics and outcomes of patients with mass-forming lesions in the liver based on their pathogenesis. A retrospective analysis was undertaken from January 2012 to December 2017. We analyzed the 222 medical records of all patients who had curative-intent hepatic resection for mass-forming, pathologically proven primary liver cancer. Analyses included clinical, pathological, and survival characteristics. Hepatocellular carcinoma (HCC) was the most prevalent tumor type (43.4%), followed by papillary cholangiocarcinoma (CCA) (27.6%), tubular CCA (22.6%), adenosquamous carcinoma (ASC) (4.1%), and small duct, mass-forming cholangiocarcinoma (SD-CCA) (2.3%). HCC and SD-CCA patients had a considerably greater survival rate than CCA and ASC patients. HCC, SD-CCA, papillary CCA, tubular CCA, and ASC had median survivals of 1373, 1180, 591, 447, and 205 days. Tumors in large duct pathogenesis are usually associated with increased rates of hilar invasion, lymph node involvement, and positive surgical margin. ASC is associated with a significantly poorer prognosis. Small duct pathogenesis tumors exhibit several shared characteristics and demonstrate a more favorable prognosis. Tumors in large duct pathogenesis are usually associated with increased rates of hilar invasion, lymph node involvement, and positive surgical margin. ASC is associated with a significantly poorer prognosis.