A comparison of the surgical results in patients with hepatitis B versus hepatitis C-related hepatocellular carcinoma

Abstract

To assess the differences in the surgical results between patients with hepatitis B- and hepatitis C-related hepatocellular carcinoma (HCC), the operative outcomes of 30 patients with hepatitis B surface antigen (HBsAg)-positive (the B-HCC group) and 96 patients with hepatitis C antibody (HCVAb)-positive (the C-HCC group), who had undergone hepatic resection from 1989 to 1993, were compared. The mean age of the patients in the C-HCC group was higher than that in the B-HCC group (61.7 years vs. 57.0 years, P < .05). The C-HCC group demonstrated both a greater decrease in liver function and a larger enhancement of inflammatory changes in the liver under a pathological examination (the current rate of active hepatitis: 69% vs. 27%, P < .001). There was also a higher incidence of total postoperative complications in the C-HCC group (60% vs. 37%, P < .05); however, regarding each individual complication, the rate was similar between the two groups. Two of the six patients with postoperative hepatic failure in the C-HCC group died. The mortality rate in the C-HCC group was 2%, but no operative death was encountered in the B-HCC group. The crude survival and the disease-free survival rates at 5 years were similar, 61.8% and 46.2% in the B-HCC group and 52.8% and 23.2% in the C-HCC group, respectively. The patterns of recurrence were also similar in both groups. The pathological features of HCC were similar between the two groups. In conclusion, the surgical results between the two groups were almost identical.(ABSTRACT TRUNCATED AT 250 WORDS)

Predictors of Recurrence in Hepatitis C Virus Related Hepatocellular Carcinoma after Hepatic Resection: A Retrospective Cohort Study

“…However it has been widely evaluated and showed low prognostic significance regarding HCC recurrence after hepatic resection for both HCV and HBV related HCCs [10,13,16,30]. Few studies had shown that pTNM staging provides a significant predictor for recurrence in HCV related HCCs [3] and HBV related HCCs [9,11,31]. This significant correlation was similar to the findings in our study.…”

“…In our study tumour recurrence occurred in 88 patients (42.3%) and most recurrences occurred in the liver (77.3%). The cumulative recurrence rates of HCV related HCCs are higher than HBV related HCCs [9][10][11]. This could be explained by the high viral replication and hepatic inflammation in HCV related HCCs.…”

“…Also, HCV related HCCs have a higher incidence of tumour multicentricity [9,10]. Recently, it is found that HCV related HCCs are associated with expression of Twist (a regulator of mesenchymal cells transition), which plays an important role in invasiveness and metastasis [11]. • IIIa 27 13%…”

Clinicopathological Criteria for Multicentricity of Hepatocellular Carcinoma and Risk Factors for Such Carcinogenesis

“…The mean age at detection of HCC is lower for patients with HBsAg alone than for patients with HCV infection. 7,14,15,49) The likelihood of multicentric carcinogenesis is low in patients with HBsAg, because the HCC often develops before cirrhosis. 11,49) The results in this study indicate that the clinicopathological criteria for multicentric HCC are of practical value and that HCV infection and a combination of current HCV infection and prior infection of HBV (perhaps with an integrated HBV gene or genes) are strong risk factors for multicentric HCCs.…”

“…The difference in the incidence of HCC in patients with HCV or HBV affects decisions about treatment, because these viruses are factors in the outcome after surgery. 14,15) HCV-related HCCs tend to be multifocal, 7,9) but no large-scale studies on the incidence of and risk factors for multicentric occurrence of HCC have been reported. We retrospectively evaluated criteria for identification of multicentric HCCs from clinicopathological findings, examined the clinical differences among patients with single HCC, multicentric HCCs, and HCCs with intrahepatic metastasis, and investigated risk factors in multicentric carcinogenesis, especially the roles of HCV and HBV.…”