Scirrhous hepatocellular carcinoma: Comparison with usual hepatocellular carcinoma based on CT-pathologic features and long-term results after curative resection

Objective: To compare the CT and pathologic features and the long-term results of scirrhous hepatocellular carcinoma (HCC) after a curative resection with those of usual HCC. Methods: Twenty-one patients with a scirrhous HCC and 296 patients with a usual HCC underwent contrast-enhanced triple-phase helical CT examinations before and after the curative resection. The CT and pathological features of scirrhous HCC, along with the cumulative survival and recurrence rates after the curative resection using a Kaplan-Meier method were compared with those of a usual HCC. Results: The common CT features of scirrhous HCC were an ill-defined tumor margin (76%), peripheral rim-like enhancement on arterial and portal phases (62%), presence of area of prolonged and delayed enhancement on equilibrium phase (95%), and hepatic surface retraction (59%) and the uncommon CT features were presence of washout area (19%) and tumor capsule enhancement (5%), which were significantly different from those of usual HCC (p < 0.05). Pathologically, the tumor capsule formation (29%) and tumor necrosis or hemorrhage (10%) were significantly less than those (81% and 43%, respectively) in usual HCC (p < 0.05), while portal or hepatic vein involvement (33%) was significantly more common than in usual HCC (9%) (p < 0.05). There were no statistically significant differences in the 5-year cumulative survival and recurrence rates between the two groups (p > 0.05). Conclusion: Scirrhous HCC showed distinct CT and pathologic features from those of usual HCC. After the curative resection, the long-term results of scirrhous and usual HCCs were not significantly different