ĐẶC ĐIỂM GIẢI PHẪU BỆNH VÀ MỘT SỐ YẾU TỐ TIÊN LƯỢNG UNG THƯ BIỂU MÔ TẾ BÀO GAN SAU PHẪU THUẬT

Abstract

Objective: Hepatocellular carcinoma (HCC) represents a significant global cancer burden, with relatively poor prognosis following hepatic resection. This study aimed to describe certain histopathological characteristics of HCC according to the 2019 World Health Organization (WHO) classification and to evaluate their association with patient survival. Methods: A retrospective, cross-sectional study with longitudinal follow-up was conducted on 330 HCC patients who underwent liver resection at K Hospital, Tan Trieu branch. Histopathological features were recorded and analyzed. Kaplan-Meier method was used to estimate survival rates; univariate and multivariate analyses were performed. Results: Stage IB and II accounted for 45.8% and 39.4% of cases, respectively. Liver fibrosis in non-tumorous tissue was mainly F2–F3. The predominant histological subtype was the conventional type (82.4%), followed by macrotrabecular (12.4%). Moderate differentiation was most common (62.7%), while poor differentiation was found in 31.8%. Vascular invasion was present in 45.8%, perineural invasion in 2.1%, and tumor necrosis in 51.5%. There were 66 deaths among 263 cases, with a mean survival time of 35.6 ± 15.2 months. The 1-, 2-, and 3-year overall survival rates were 90.9%, 82.5%, and 74.5%, respectively. Univariate analysis identified age, tumor size, TNM stage, macrotrabecular subtype, histological grade, vascular invasion, tumor necrosis, and fibrosis stage as prognostic factors. Multivariate analysis revealed poor differentiation and advanced fibrosis (F4–6) as independent prognostic factors. Conclusion: The conventional subtype is the most common histological pattern. Vascular invasion and tumor necrosis are frequently observed. Histopathological features such as fibrosis stage, subtype, histological grade, vascular invasion, and tumor necrosis are associated with survival prognosis, with poor differentiation and advanced fibrosis being independent predictors.