Hepatocellular Carcinoma Cancer Protocol



Hepatocellular Carcinoma Cancer Protocol


Laura Webb Lamps, MD










Hepatocellular Carcinoma: Hepatic Resection
















































































































































































































































































































































































































Surgical Pathology Cancer Case Summary (Checklist)


Specimen (select all that apply)



___Liver



___Gallbladder



___Other (specify):____________________



___Not specified


Procedure (select all that apply)



___Wedge resection



___Partial hepatectomy




*___Major hepatectomy (3 segments or more)




*___Minor hepatectomy (< 3 segments)



___Other (specify):____________________



___Not specified


Tumor Size



Greatest dimension: _____ cm



*Additional dimensions: _____ x _____ cm



___Cannot be determined


Tumor Focality



___Solitary (specify location):____________________



___Multiple (specify location:____________________


Histologic Type



___Hepatocellular carcinoma



___Fibrolamellar hepatocellular carcinoma



___Undifferentiated carcinoma



___Other (specify):____________________



___Carcinoma, type cannot be determined


Histologic Grade



___Not applicable



___GX: Cannot be assessed



___GI: Well differentiated



___GII: Moderately differentiated



___GIII: Poorly differentiated



___GIV: Undifferentiated/anaplastic



___Other (specify):____________________


Tumor Extension (select all that apply)



___Tumor confined to liver



___Tumor involves a major branch of portal vein



___Tumor involves 1 or more hepatic vein(s)



___Tumor involves visceral peritoneum



___Tumor directly invades gallbladder



___Tumor directly invades other adjacent organs (specify):____________________


Margins (select all that apply)



Parenchymal margin




___Cannot be assessed




___Uninvolved by invasive carcinoma





Distance of invasive carcinoma from closest margin: _____ mm





Specify margin:______________




___Involved by invasive carcinoma



Other margin




Specify margin:____________________




___Cannot be assessed




___Uninvolved by invasive carcinoma





Distance of invasive carcinoma from closest margin: _____ mm





Specify margin:______________




___Involved by invasive carcinoma



Other margin




Specify margin:____________________




___Cannot be assessed




___Uninvolved by invasive carcinoma




___Involved by invasive carcinoma


Lymph-Vascular Invasion



Macroscopic venous (large vessel) invasion (V)




___Not identified




___Present




___Indeterminate



Microscopic (small vessel) invasion (L)




___Not identified




___ Present




___ Indeterminate


*Perineural Invasion



*___ Not identified



*___ Present



*___ Indeterminate


Pathologic Staging (pTNM)



TNM descriptors (required only if applicable) (select all that apply)




___ m (multiple primary tumors)




___ r (recurrent)




___ y (post-treatment)



Primary tumor (pT)




___ pTX: Cannot be assessed




___ pT0: No evidence of primary tumor




___ pT1: Solitary tumor without vascular invasion




___ pT2: Solitary tumor with vascular invasion or multiple tumors, none > 5 cm




___ pT3a: Multiple tumors > 5 cm




___ pT3b: Single tumor or multiple tumors of any size involving a major branch of portal vein or hepatic veins




___ pT4: Tumor(s) with direct invasion of adjacent organs other than gallbladder or with perforation of visceral peritoneum



Regional lymph nodes (pN)




___ pNX: Cannot be assessed




___ pN0: No regional lymph node metastasis




___ pN1: Regional lymph node metastasis





Specify: Number examined: __________






Number involved: __________



Distant metastasis (pM)




___ Not applicable




___ pM1: Distant metastasis





*Specify site(s), if known: ______________________________


*Additional Pathologic Findings (select all that apply)



*Fibrosis score:



*___ Cirrhosis/severe fibrosis (Ishak score 5-6) (F1)



*___ None to moderate fibrosis (Ishak score 0-4) (F2)



*___ Hepatocellular dysplasia





*___ Low-grade dysplastic nodule





*___ High-grade dysplastic nodule



*___ Steatosis



*___ Iron overload



*___ Chronic hepatitis (specify etiology): ______________________________



*___ Other (specify): ______________________________



*___ None identified


*Ancillary Studies



*Specify: ______________________________


*Clinical History (select all that apply)



*___ Cirrhosis



*___ Hepatitis C infection



*___ Hepatitis B infection



*___ Alcoholic liver disease



*___ Obesity



*___ Hereditary hemochromatosis



*___ Other (specify): ______________________________



*___ Not known


* Data elements with asterisks are not required. However, these elements may be clinically important but they are not yet validated or regularly used in patient management. Adapted with permission from College of American Pathologists, “Protocol for the Examination of Specimens from Patients with Hepatocellular Carcinoma.” Web posting date October 2009, www.cap.org.

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Jul 7, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Hepatocellular Carcinoma Cancer Protocol
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