Proposal of new classification for postoperative patients with hepatocellular carcinoma based on tumor growth characteristics

Figure 1 Growth characteristics of hepatocellular carcinoma. HCC: Hepatocellular carcinoma.

Figure 2 Overall survival curves for patients with expansive tumor growth and invasive tumor growth. A: No significant difference in survival was observed between patients with a single tumor and patients with multiple tumors. Moreover, no significant difference in survival was observed among patients with satellite nodules, patients with nodule fusion and patients with tumor invasion of adjacent organs; B: Based on the data, patients were divided to two groups: expansive tumor growth (single tumor and multiple tumors) and invasive tumor growth (satellite nodules, nodule fusion and tumors with direct invasion of adjacent organs). The overall survival was 57.398 ± 4.873 mo for patients with expansive tumor growth, while it was 27.796 ± 3.730 mo for patients with invasive tumor growth (P < 0.001).

Figure 3 Overall survival curves for patients with disseminative growth. A: No significant difference in survival was observed between patients with vascular involvement of tumor and patients with regional lymph node metastasis. The overall survival (OS) of patients with tumors that lacked vascular and regional lymph node involvement was longer than those of other groups, while the OS of patients with distant metastasis was shorter than those of other groups; B: Based on these data, patients were divided into three groups: tumors without vascular and regional lymph node involvement, tumors with vascular and/or regional lymph node involvement and distant metastasis.

Figure 4 New classification for hepatocellular carcinoma. A: Overall survival (OS) curves for patients based on tumor-node-metastasis system classification; B: OS curves for patients with expansive growth, invasive growth and disseminative growth; C: OS curves for patients based on Expansive-Invasive-Disseminative growth (EID) staging classification; D: OS curves for patients with different levels of alpha-fetoprotein (AFP); E: OS curves for patients based on EID staging classification and AFP; F: Overall survival curves for patients combined EID staging classification and AFP.