Clinicopathologic characteristics of patients with non-B non-C hepatitis virus hepatocellular carcinoma after hepatectomy
Department of Surgery, Hirakata Hospital, Kansai Medical University, 2-3-1 Shinmachi, Hirakata, Osaka 573-1191, Japan. American journal of surgery
(Impact Factor: 2.29).
05/2012; 204(3):300-7. DOI: 10.1016/j.amjsurg.2011.11.014
A substantial population of hepatocellular carcinoma (HCC) patients is negative for markers of hepatitis B virus and hepatitis C virus (HCV) infection (non-B non-C hepatitis virus [NBC]).
Clinicopathologic data and outcomes were compared retrospectively for HCC patients with hepatitis B virus, HCV, and NBC who had undergone hepatectomy.
The TNM stage was significantly higher, and the prevalence of cirrhosis was significantly lower, in the NBC group compared with the HCV group. Among patients with a maximum tumor diameter of 5 cm or less, the survival rates were significantly higher in the NBC group than in the HCV group. Multivariate analysis revealed that preoperative serum des-gamma-carboxy prothrombin (DCP) level was a prognostic factor for survival in NBC-HCC patients. The DCP/tumor size ratio was significantly higher in NBC-HCC patients with normal liver histology than in patients with hepatitis or cirrhosis.
NBC-HCC patients had more advanced tumors compared with HCV-HCC patients, but significantly higher survival rates. Measurement of DCP potentially is significant for early diagnosis of NBC HCC, which may increase the chance of curative therapy without recurrence.
Available from: Masashi Kishiwada
- "It remains controversial whether NBNC-HCC patients have comparable prognosis to HCC patients with HBV or HCV. In the previous studies, NBNC-HCC patients had a poorer prognosis than hepatitis virus-related HCC patients because NBNC-HCCs were often detected at an advanced stage incidentally without followup   . In contrast, a few "
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ABSTRACT: We evaluated clinicopathological factors affecting survival and recurrence after initial hepatectomy in non-B non-C (NBNC) hepatocellular carcinoma (HCC) patients with comparison to hepatitis B or C virus, paying attention to relationship between alcohol consumption and histopathological findings. The medical records on the 201HCC patients who underwent initial hepatectomy between January 2000 and April 2013 were retrospectively reviewed. NBNC patients had higher prevalence of hypertension (47.4%), diabetes mellitus (35.5%), alcohol consumption (>20 g/day) (61.8%), and preserved liver function than hepatitis B or C patients. The 5-year survival rate of NBNC patients (74.1%) was significantly better than hepatitis B (49.1%) or C (65.0%) patients (NBNC versus B,
). Among the NBNC patients, there was no relationship between alcohol consumption and clinicopathological findings including nonalcoholic fatty liver disease activity score (NAS). However, the 5-year OS and RFS rates in the alcohol-unrelated NBNC patients tend to be better than in the alcohol-related. By multivariate analysis, independent factors for OS in NBNC patients were Child-Pugh B/C, intrahepatic metastasis (im), and extrahepatic recurrence. NBNC patients, who were highly associated with lifestyle-related disease and preserved liver function, had significantly better prognosis compared to hepatitis B/C patients; however, there was no association between alcohol consumption and histopathological findings.
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ABSTRACT: Background/Aim: We aimed to examine the relationship between antibodies to hepatitis B core antigen (anti-HBc) positivity and survival in patients with non-B non-C hepatocellular carcinoma (NBNC-HCC) who underwent curative treatment.
A total of 260 patients with NBNC-HCC who underwent curative therapy were analyzed. They included 124 anti-HBc-positive patients (47.7%) and 136 anti-HBc-negative patients (52.3%). Overall survival (OS) and recurrence-free survival (RFS) rates were compared.
The 3-year cumulative OS rates were 75.9% in the anti-HBc-positive group and 82.3% in the anti-HBc-negative group (p=0.069). The corresponding RFS rates were 29.8% in the anti-HBc-positive group and 43.0% in the anti-HBc-negative group (p=0.001). Multivariate analyses identified anti-HBc positivity (p=0.006), aspartate aminotransferase ≥40 IU/l (p=0.037) and des-γ-carboxy prothrombin ≥100 mAU/ml (p=0.046) as significant adverse predictors were linked to RFS.
Anti-HBc positivity can be a useful predictor for recurrence in patients with NBNC-HCC after curative therapy.
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ABSTRACT: The impact of obesity on survival after curative treatment for non-B non-C hepatocellular carcinoma (NBNC-HCC) remains unclear. This study examined the prognostic impact of obesity in patients who received curative therapy for NBNC-HCC.
A total of 260 patients with NBNC-HCC who underwent curative therapy were analyzed. They included 116 obese patients (44.6%) with a body mass index (BMI) >25 kg/m2 (obesity group) and 144 control patients (55.4%) with a BMI <25 kg/m2 (control group). Overall survival (OS) and recurrence-free survival (RFS) rates were compared.
The median observation periods in the obesity and control groups were 3.1 and 3.0 years, respectively. The 1-, 3- and 5-year cumulative OS rates were 93.9%, 77.3% and 56.0% in the obesity group, and 98.8%, 77.3% and 62.1% in the control group, respectively (p = 0.955). The corresponding RFS rates were 74.6%, 28.0% and 19.0% in the obesity group, and 70.0%, 44.3% and 28.9%, in the control group, respectively (p = 0.128). Multivariate analyses identified a serum albumin >4.0 g/dL (hazard ratio [HR], 1.759; 95% confidence interval [CI], 1.007-3.074; p = 0.047) and des-γ-carboxy prothrombin >100 mAU/mL (HR, 0.396; 95% CI, 0.243-0.646; p < 0.001) as independent factors linked to OS. Alkaline phosphatase>300 IU/L (HR, 0.549; 95% CI, 0.367-0.823; p = 0.004) and gamma-glutamyl transferase >100 IU/L (HR, 0.679; 95% CI, 0.471-0.978; p = 0.038) were significant adverse predictors linked to RFS.
Obesity does not affect survival in patients with NBNC-HCC after curative therapy.
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