Hepatocellular carcinoma (HCC) with or without cirrhosis in autopsy cases were compared clinically and pathologically. Seventy-five patients with HCC were autopsy cases: 51 had cirrhosis and 24 did not. The patients had been admitted between 1976 and 1986 and were studied in regard to age, sex, clinical onset, past history of hepatic disease, concomitant illness, etiologic factors (HB virus, blood transfusion and alcoholic history), cause of death, extrahepatic metastasis, time span between onset and death, size of the liver and spleen, mode of metastasis, tumor size, degree of anaplasia and also cancer cell histology, metastasis in patients who had received a transhepatic arterial embolization (TAE).
Differences were found between the cirrhotic and non-cirrhotic groups with respect to past history of hepatic disease, history of alcoholic abuse and cause of death. Notably in non-cirrhotic HCC, death was due to infection in many cases.
Additionally extrahepatic metastasis was compared with respect to tumor type and degree of anaplasia. The incidence of metastasis was over 5 cm in solitary nodule cases.
Patients with hematogenous metastasis alone were found in many cases to have multiple nodule type tumors in both the cirrhotic and non-cirrhotic groups. The rate of extrahepatic metastasis was high in patients with anaplasia III and IV in both groups, but the incidence of hematogenous metastasis was particularly high in anaplasia I and II in HCC with cirrhosis. Cancer cell histology was not correlated with extrahepatic metastasis. All the patients treated with TAE were shown to have metastasis in the autopsy. However, the patterns of metastasis in these patients were similar to those in patients who did not receive TAE.