Clinical prognostic factors for fibrolamellar liver carcinoma

BACKGROUND: Fibrolamellar liver carcinoma is a rare subtype of liver cancer with an unexplored etiology. There is no information about the choice of classification for fibrolamellar liver carcinoma (FLC) in the world literature, and data on the prognostic significance of clinical aspects in FLC are very contradictory and require further study.

AIM: To evaluate the practical significance of staging systems for operable hepatocellular cancer for fibrolamellar carcinoma (TNM/AJCC, BCLC) as a separate option, to study the influence of clinical aspects (disease stage, gender, age, size of tumor) of patients with FlC on the long-term results of their treatment.

MATERIALS AND METHODS: The retrospective study included 34 patients with FlC who underwent radical surgical treatment at the first stage at the Blokhin National Research Institute of Oncology of the Ministry of Health of the Russian Federation from 2005 to 2020.

RESULTS: When assessing the prevalence of the disease according to the TNM-8/AJCC system, a significant correlation between the FlC stage and the prognosis was revealed. It is proved that the greatest RFS was achieved in the group of stages II–IIIB, while the smallest RFS was achieved in the group with stage IVB (p=0.002; p=0.000). The highest OS was achieved in the group of stages II–IIIB, while the lowest OS was achieved in the group with stage IVB (p=0.050; p=0.000). The OV of patients with FlC was not dependent

CONCLUSIONS: The TNM-8/AJCC classification optimally predicts the results of surgical treatment of FlC. The use of the Barcelona staging system for this subtype of liver cancer is impractical. The size of the primary tumor, as part of the FlC staging system, turned out to be an independent prognostic factor. The age of the patient ≥20 years correlates with the deterioration of OV.