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10.1245/s10434-006-9299-y
Annals of Surgical Oncology 14:1170-1181 (2007)
© 2007 Society of Surgical Oncology
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Original Article

Clinical Characteristics and Surgical Outcome in Hepatocellular Carcinoma without Hepatitis B Virus Surface Antigen or Hepatitis C Virus Antibody

Kuniya Tanaka, MD, PhD2, Hiroshi Shimada, MD, PhD1, Kenichi Matsuo, MD1, Yasuhiko Nagano, MD1, Itaru Endo, MD, PhD1 and Shinji Togo, MD, PhD1

1 Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
2 Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan

Correspondence: Address correspondence and reprint requests to: Kuniya Tanaka, MD PhD; E-mail: ktrj112{at}urahp.yokohama-cu.ac.jp

Objective: We investigated clinical characteristics and surgical outcome of hepatocellular carcinoma in association with hepatitis viral status.

Summary Background Data: No consensus exists concerning differences in surgical outcome in patients with hepatocellular carcinoma according to viral hepatitis status, especially those negative for hepatitis B virus surface antigen and antibody to hepatitis C virus.

Methods: Clinicopathologic data were available for 39 hepatectomy patients with hepatocellular carcinoma who were negative for hepatitis B virus surface antigen and hepatitis C virus antibody. Clinical characteristics and surgical outcome were analyzed retrospectively and compared to those patients with positive hepatitis viral markers.

Results: Patients negative for viral hepatitis markers were more likely to have large, advanced-stages tumors with relatively well-preserved liver function and had a lower incidence of intrahepatic recurrences (P = 0.009). The intrahepatic recurrence rate reached a plateau at approximately 3 years after resection in patients with negative viral markers, while it continued to increase steadily in patients positive for viral hepatitis markers. By multivariable analysis, the absence of viral hepatitis markers predicted a decreased rate of intrahepatic recurrence (relative risk, 0.222; P = 0.001).

Conclusions: Adequate surgical resection in hepatocellular carcinoma patients negative for viral markers offers a good survival benefit, regardless of the etiology of the hepatocellular carcinoma.

Key Words: hepatocellular carcinoma • viral hepatitis marker • intrahepatic recurrence • survival outcome

Abbreviations: AFP, {alpha}-fetoprotein • AWD, alive with disease • BMI, body mass index • CLIP, Cancer of the Liver Italian Program • DFD, died from the disease • DOD, died from other diseases • HA, hyaluronic acid • HBcAb, anti-HB core antibody • HBsAg, hepatitis B virus surface antigen • HBV, hepatitis B virus • HCC, hepatocellular carcinoma • HCV, hepatitis C virus • HCVAb, hepatitis C virus antibody • ICGR15, indocyanine green retention rate at 15 min • JIS, Japan Integrated Staging • Moderate, moderately differentiated hepatocellular carcinoma • NAFLD, nonalcoholic fatty liver disease • NED, no evidence of disease • non-B non-C, neither hepatitis B virus surface antigen nor hepatitis C virus antibody • Poor, poorly differentiated hepatocellular carcinoma • PS, prediction score • RR, relative risk • Well, well differentiated hepatocellular carcinoma






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Copyright © 2007 by the Society of Surgical Oncology.