Problems of Long Survival Following Surgery in Patients with NonBNonC-HCC: Comparison with HBV and HCV Related-HCC

Abstract

Background: The number of patients with hepatocellular carcinoma (HCC) in the absence of both hepatitis B virus surface antigen (HBsAg) and hepatitis C virus antibody (HCVAb) (NBNC-HCC) has been rapidly increasing in Japan. The objective of this study was to compare the clinical and pathological characteristics between patients with the NBNC-HCC, those with HBsAg positive HCC (B-related HCC) and HCVAb positive HCC (C-related HCC). A better understanding will facilitate the development of postoperative strategies to better manage patients with NBNC-HCC.Methods: Consecutive 219 patients with primary HCC: (B-related, n=35; C-related, n = 104; NBNC, n = 80) were treated by hepatic resection or ablation. Clinicopathological characteristics including postoperative course were retrospectively compared between the three groups.Results: When comparing within stage I and II, the NBNC-HCC group had improved recurrence free survival (RFS) compared to the C-related HCC (p = 0.013) but had not been good overall survival (OS). Moreover, the NBNC-HCC group showed higher rate of death due to other cancers and cardiovascular disease (p = 0.011) compared to the C-related HCC. Multivariate analysis revealed that the only prognostic factor for RFS in the NBNC-HCC group was high serum total bilirubin.Conclusions: In the patients with the NBNC-HCC, elevated serum bilirubin could predict poor RFS after surgery. Furthermore, patients must be carefully followed-up not only for HCC but also for the occurrence of other critical diseases including multiple other cancers.

The Impact of Tumor Size on Long-Term Survival Outcomes After Resection of Solitary Hepatocellular Carcinoma: Single-Institution Experience with 2558 Patients

“…33 In a Japanese study with 219 HCC patients, the prognostic factors were different according to the background liver diseases. 34 The condition of the underlying liver in HCC patients is one of the most important factors to decide treatment modality as well as to alter the survival outcomes. Although HCC most commonly occurs in the cirrhotic liver, approximately 10 to 40 % of cases develop against non-fibrotic to moderately fibrotic parenchyma.…”

Correlation between serum prealbumin and prognosis of patients with hepatocellular carcinoma after hepatectomy

“…The high rate of recurrence and low rate of OS after hepatectomy in preoperative neutrophil-to-lymphocyte ratio, and other factors. [7][8][9][10] Because prealbumin reflects liver functional levels, 4,11 we examined its ability to predict OS after hepatectomy in a cohort of patients treated at our hospital. We found that it may be useful for predicting prognosis, and this finding was robust to subgroup analyses based on several clinicopathological variables.…”

A Preliminary Predictive Model of Post - Transplant Tumor Recurrence in Hepatitis B Virus Associated Hepatocellular Carcinoma - Epidemiological and Therapeutic Implications

“…Recently researchers have opined that long non-coding RNA PVT1 is associated with tumor progression and is a significant predictor of recurrence in liver cancer patients [9]. Contrarily, reports indicate that in patients with NBNC-HCC profile (patients with HCC in absence of both hepatitis B virus surface antigen, HBsAg and hepatitis C virus antibody, HCVAb), elevated serum bilirubin could predict poor recurrencefree survival after surgery [10]. Studies have also revealed low serum IL-6 level to be an independent prognostic factor for disease-free survival together with low platelet count and low serum albumin level, in patients with HBVrelated early HCC who underwent hepatic resection or radiofrequency ablation with a curative intent [11].…”