Clinicopathologic Features and Long-Term Outcomes of Chinese Patients with Hepatocellular Carcinoma in Non-Cirrhotic Liver

Abstract

Background/Aims: Most hepatocellular carcinomas (HCC) are associated with cirrhosis. The clinicopathologic characteristics and outcomes of HCC present in non-cirrhotic livers are not well known in Chinese patients. This study was performed to explore the features of these patients and their outcomes after hepatectomy. Methods: 96 patients with histologically confirmed HCC in non-cirrhotic liver who underwent partial hepatectomy between 1995 and 2001 in our cancer center were reviewed. A retrospective analysis of the clinicopathologic features was performed, and survival of patients was analyzed by the Kaplan-Meier method and Cox regression model. Results: Operative mortality and morbidity were none and 8.3% (8/96), respectively. Postoperative overall survival (OS) rates at 1, 3, 5 and 10 years were 84.4, 62.5, 47.9 and 38.2%, respectively, with a median OS of 57 months. Disease-free survival (DFS) rates at 1, 3, and 5 years were 56.3, 39.6, and 33.3%, respectively, with a median DFS of 18 months. TNM stage was an independent prognostic factor for both OS and DFS of non-cirrhotic HCC. Operative blood loss was an independent prognostic factor for OS and DFS of patients who received curative resection. Conclusion: Curative partial hepatectomy was an effective and safe treatment for non-cirrhotic HCC. Aggressive local therapies were recommended for patients with intrahepatic recurrence.

Hepatocellular cancer in the non-cirrhotic liver

“…This is due to a subset of HCC on NCL that arises in the second and third decades [5]. It is within this age group that we see the unusual entity of fibrolamellar HCC (mean age of 27 years) [6].…”

“…Male predominance is less marked for HCC on NCL (75% men for HCC on NCL versus 85% for HCC on cirrhosis); more strikingly, the sex ratio is equal in patients younger than 50 years [4,5].…”

“…In the case of unresectable extrahepatic recurrence, chemotherapy or systemic treatment with Sorafenib can be considered (though it has not been validated for this indication). Prolonged survival is possible, even in case of recurrence [5].…”

Place of liver transplantation in the treatment of hepatocellular carcinoma in the normal liver

“…Liver Resection [7][8][9][10][11][12][13][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] (Table 1) The articles reviewed for information on partial liver resection for NC-HCC include 2263 patients; the numbers of patients in these series range from 20 to 254. [7][8][9][10][11][12][13][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] The results of the French multicenter ...…”

“…[7][8][9][10][11][12][13][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] The results of the French multicenter study, 1 which includes the world's largest series of resections for HCC arising in normal livers (ie, nonfibrotic and noncirrhotic), are discussed separately. The larger studies come from regions with high rates of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections.…”