Prognostic value of desmoplastic growth patterns in resected hepatocellular carcinoma

IntroductionThe prognostic value of histopathological growth patterns (HGPs) is well established in liver metastases, but their significance in hepatocellular carcinoma (HCC) remains uncertain. This study examined the prognostic relevance of the desmoplastic HGP (dHGP) in HCC and explored the impact of the degree of desmoplasia using three assessment methods.MethodsWe retrospectively analysed 99 patients resected for HCC at two Finnish centres; 74 had adequate tissue for evaluation. HGP was classified as uniform dHGP (44/74) or predominant dHGP (66/74). The degree of desmoplasia was visually estimated as the minimum, maximum, and average distance between tumour cells and adjacent liver parenchyma.ResultsUniform dHGP was not associated with survival in multivariable analysis. Predominant dHGP independently predicted improved overall survival (HR 0.15, 95% CI 0.04–0.51, P = 0.003) and disease-specific survival (HR 0.16, 95% CI 0.04–0.73, P = 0.018). A higher degree of desmoplasia showed a tendency toward better disease-specific survival across all measurement methods, although these associations did not remain significant in multivariable models.ConclusionPredominant dHGP is associated with favourable long-term outcomes in resected HCC, whereas uniform dHGP shows no prognostic value. The potential of desmoplasia as a prognostic biomarker warrants further study.