Hepatocellular carcinoma in patients without cirrhosis: relevance and clinical characteristics

Carvalho, Kellyane Santana Dias; Fonseca, Luciano Espinheira; Cotrim, Helma Pinchemel

doi:10.20517/2394-5079.2018.13

Cited by 3 publications

(5 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The fraction of HCC patients without cirrhosis has been reported variously as 12%, 20 15%, 9 16%, 21 and 36% 22 overall, and up to 37% 23 or 40% 24 in subgroups with NAFLD. A prior study of OPTN HCC transplant patients with cirrhosis 6 included 13 797 persons aged 35-74.…”

Section: Discussionmentioning

confidence: 99%

Life Expectancy after Liver Transplantation for Non-Cirrhotic Hepatocellular Carcinoma

Shavelle¹,

Kwak²,

Saur³

et al. 2021

Prog Transpl

View full text Add to dashboard Cite

Background: Hepatocelluar carcinoma typically occurs with underlying cirrhosis. However roughly 20% of cases arise in a non-cirrhotic liver. There is limited literature that addresses the long-term survival of the narrow subgroup who received transplantation. For such patients we sought to calculate life expectancies both at time of transplant and several years later, stratified by key risk factors, and to determine if survival has improved in recent years. Such information can be helpful in making treatment decisions. Methods: Data on 4,373 non-cirrhotic HCC patients who underwent liver transplantation in the MELD era (2002-2018) from the United States OPTN database were analyzed using the Cox proportional hazards regression model and life table methods. Results: Demographic and past medical history factors related to survival were patient age, donor age over 20, and the presence of ascites or severe hepatic encephalopathy. Survival did not vary by race or sex. HCC-specific factors significantly related to survival were the total number of tumors, extrahepatic spread, lymph node involvement, satellite lesions, micro- or macrovascular invasion, tumor differentiation (grade), and pre-transplant treatment. Survival improved over the study period, at 4% per calendar year during the first 5 years post transplant and 1% per year thereafter. Conclusions: Life expectancy in non-cirrhotic HCC transplant patients is much reduced from normal, and varies according to age and tumor-related factors. Survival improved modestly over the study period.

show abstract

Section: Discussionmentioning

confidence: 99%

Life Expectancy after Liver Transplantation for Non-Cirrhotic Hepatocellular Carcinoma

Shavelle¹,

Kwak²,

Saur³

et al. 2021

Prog Transpl

View full text Add to dashboard Cite

show abstract

“…The hepatic parenchyma surrounding noncirrhotic HCC can be entirely normal but usually shows some degree of fibrosis (41-65%), inflammation (50%), early steatosis (36%), or iron accumulation. (3,8,11) In our patient, the fibroscan revealed Metavir F3. It was severe fibrosis.…”

Section: Discussionmentioning

confidence: 52%

“…The appearance is variable and non-specific, ranging from hypo or hyperechoic lesions with or without heterogeneity or necrotic areas. (1,3,9) In this case, the USG abdomen revealed hepatomegaly with two solid masses in the right lobe, suspicious of multifocal hepatoma. The abdominal CT scan can diagnose HCC with a high degree of confidence.…”

Section: Discussionmentioning

confidence: 69%

“…This uncommon presentation posed each a diagnostic and management challenge. (3,4,13) In this patient with regarded multifocal HCC, duodenal lesions equivalent to liver parenchyma have been discovered endoscopically and laparotomy, elevating the suspicion that those lesions have been metastasis deposits of HCC. Most duodenal involvement with HCC results from local extension of the primary tumor, but the CT scan and laparotomy proved no local invasion into the small bowel.…”

Section: Discussionmentioning

confidence: 83%

“…Furthermore, Hematogenous or lymphatic metastasis to the duodenum is extraordinarily rare. (3,4) The present case report describes a 67-year-old man patient admitted to the hospital with recurrent hematemesis melena; he was diagnosed with HCC with duodenal metastasis in chronic HBV infection.…”

Section: Introductionmentioning

confidence: 94%

See 2 more Smart Citations

Non-Cirrhotic Hepatocellular Carcinoma with Duodenal Metastasis in Chronic Hepatitis B: Case Report

Suputra¹

2022

International Journal of Scientific Advances

View full text Add to dashboard Cite

Background: Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the second leading cause of cancer-related death. The extrahepatic extension is also more common in non-cirrhotic HCC. It most commonly metastases to the regional lymph nodes, bone, and lungs. Metastasis to the small bowel is rare. Further, hematogenous metastasis to the duodenum is incredibly rare. Case: A 67-year-old man was admitted with a recurrence of hematemesis melena, weight loss, weakness, and decreased appetite. There was a history of hepatitis and a family history of liver diseases. Abdominal examination revealed a palpable liver (8 cm below the right costal margin, firm, irregular, and tender). Laboratory studies revealed Hb 5.2 g/dL, SGOT 301.1 u/L, SGPT 244.7 u/L, albumin 2.7 g/dL, HbsAg was reactive with HBV DNA 2.01 x 104 IU/ml. EGD showed that esophageal varices were not visible, the duodenum showed an irregular mass, bleeding on touch, and many blood clots. Abdominal USG revealed hepatomegaly with suspicion of multifocal hepatoma, while a CT scan suggested the appearance of HCC and no local invasion into the small bowel. The result of the fibro scan was severe fibrosis, not cirrhosis. At laparotomy, a hepatic tumor and duodenum were discovered. The histopathological study of the tumor revealed a well-differentiated HCC. The resection of the tumor could not be done. He was given palliative and symptom treatment HCC on non-cirrhotic liver remains an exceptional condition. Conclusion: We report a non-cirrhotic HCC in chronic hepatitis B infection.

show abstract

Hepatocellular carcinoma: update on treatment guidelines

Dhanaraj

Shah

O’Rourke

et al. 2020

Gastrointestinal Nursing

View full text Add to dashboard Cite

Hepatocellular carcinoma (HCC) is the most common primary liver cancer, with increasing prevalence and mortality worldwide. The greatest risk factor for HCC is liver cirrhosis; however, these patients are often asymptomatic, making them difficult to identify for surveillance. Diagnosis is made with contrast-enhanced imaging and/or liver biopsy. HCC is assessed with the validated Barcelona Clinic Liver Cancer staging system, which encompasses tumour size, liver function and patient performance status. HCC without extrahepatic manifestations or vascular invasion may be cured with surgical intervention, involving either partial resection or full resection and liver transplantation. Locoregional therapies include tumour ablation, used for minimally invasive cure of early disease, and transarterial chemo-embolisation (TACE), used for control of intermediate disease. Both ablation and TACE are also used for downstaging as a bridge to transplantation. More advanced HCC can be controlled with drug-based systemic therapies involving either an oral kinase inhibitor (e.g. sorafenib, lenvatinib or regorafenib) or intravenous immunotherapy with one or more monoclonal antibodies (e.g. atezolizumab and bevacizumab). Best outcomes in HCC management require a multidisciplinary approach, including nutritional support and palliative care. The clinical nurse specialist plays an integral role by co-ordinating the treatment care pathway and responding to patient needs.

show abstract

Hepatocellular carcinoma in patients without cirrhosis: relevance and clinical characteristics

Cited by 3 publications

References 20 publications

Life Expectancy after Liver Transplantation for Non-Cirrhotic Hepatocellular Carcinoma

Life Expectancy after Liver Transplantation for Non-Cirrhotic Hepatocellular Carcinoma

Non-Cirrhotic Hepatocellular Carcinoma with Duodenal Metastasis in Chronic Hepatitis B: Case Report

Hepatocellular carcinoma: update on treatment guidelines

Contact Info

Product

Resources

About