pathology report question...

[happymom2v]

I was trying to add to my other question...but it wouldn't let me, so I am very SORRY to start another thread...

What are the chances that the HCC can come back post transplant, either in the new liver or as a metasized cancer elsewhere in the body???

Here is Pathology:
1. The trichrome stain confirms absence of fibrosis. there is no macrovesicular steatosis or necrosis.
2. The specimen reveals a 1.2cm partially necrotic subcapsular nodule in right lobe. The necrotic nodule demonstrates residual moderately differentitated hepatocellular carcinoma.

Tumor size 1.2cm,
Solitary tumor in right lobe
Tumor Necrosis: present 80%
Tumor extension:Tumor confined to liver
Hilar margin: hilar margin is uninvolved by carcinoma
Distance of invasive carcinoma from closest margin:  5cm,
Primary tumor
pT1: solitary tumor without vascular invasion
Fibrosis score: 4

Based on this pathology report...Is there a chance HCC will come back either in new liver or as a mestastic cancer?

[Thomas D Schiano, MD]

afp could detect recurrent cancer anywhere in the body, if it were (+) before the transplant.  Recurrent hepatitis has no impact on recurrence of the cancer.  PIVKA ll is definitely bot standard of care as i am aware

[happymom2v]

Thank you very much.

Will the AFP elevate/be able to detect if the HCC spread to another organ, (example lungs) or is the AFP test only dedicated to detect HCC in the liver?

Does active Hepatitis in the new liver increase chances of the HCC coming back?

I previously asked you about the Pivka II test...why do only certain transplant centers use this test? Is this a new and upcoming test for the detection of HCC? Or is it still a "trial/experimental" test?

Thank you again.

[Thomas D Schiano, MD]

this is a safe distance

it could go to liver or lung.  there is no specific pattern per se

[happymom2v]

Thank you, Dr. Schiano.

In the pathology report it says
"Distance of invasive carcinoma from closest margin: 5cm"
Is this a "safe" distance?

If HCC does come back, typically, does it first reappear in the liver, or could it show up elsewhere first, like the lungs, then go to the liver? Is there a specific pattern that HCC follows post transplant?

[Thomas D Schiano, MD]

we scan them every 6 months.  We get CT scaan so that the chest can also be imaged, unless the person has kidnet problems, and then an MRI is done

[happymom2v]

Thank you get much, Dr. Schiano

1. How often are Post transplant patients sanned at your facility? Especially the patients that have been transplanted due to HCC?

2. How do you determine which Post transplant patients should get an Mri and which should get a CT scan?