Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Surg Oncol. 2014 Dec;110(8):976-81. doi: 10.1002/jso.23772. Epub 2014 Aug 29.
There is controversy regarding liver function of non-B, non-C hepatocellular carcinoma (NBNC-HCC) patients, the biological behavior of their tumors, and the outcome after surgical treatment. The aims of the present study were to compare clinicopathologic data and long-term clinical outcomes between NBNC-HCC patients and hepatitis B virus HCC (HBV-HCC) patients from non-cirrhotic liver after curative hepatectomy.
Data for HBV-HCC patients (n = 360) and NBNC-HCC patients (n = 103) were retrospectively reviewed.
The median age of patients in the NBNC group was significantly higher than that of the HBV group (63 years vs. 53 years, P < 0.001). Tumor size in the NBNC group was greater than that in the HBV group (5.1 cm vs. 3.8 cm, P < 0.001). Regarding liver histology, the grade of lobular activity, periportal activity, and fibrosis in the HBV group was higher than in the NBNC group (P < 0.001, P < 0.001, and P < 0.001, respectively). There were no statistically significant differences in disease-free survival and overall survival between the two groups (P = 0.257 and P = 0.579, respectively). Multivariate analysis showed that increased tumor size, microvascular invasion, and intrahepatic metastasis were associated with tumor recurrence after curative liver resection.
For patients with non-cirrhotic liver, clinical outcomes for NBNC-HCC were comparable to those for HBV-HCC after curative hepatectomy.
非乙型肝炎、非丙型肝炎肝细胞癌(NBNC-HCC)患者的肝功能、肿瘤的生物学行为以及手术治疗后的预后存在争议。本研究旨在比较非肝硬化肝脏根治性肝切除术后 NBNC-HCC 患者和乙型肝炎病毒 HCC(HBV-HCC)患者的临床病理资料和长期临床结局。
回顾性分析 HBV-HCC 患者(n=360)和 NBNC-HCC 患者(n=103)的临床资料。
NBNC 组患者的中位年龄明显高于 HBV 组(63 岁 vs. 53 岁,P<0.001)。NBNC 组肿瘤直径大于 HBV 组(5.1cm vs. 3.8cm,P<0.001)。在肝组织学方面,HBV 组的小叶活动度、门脉周围活动度和纤维化程度均高于 NBNC 组(P<0.001、P<0.001 和 P<0.001)。两组患者的无病生存率和总生存率无统计学差异(P=0.257 和 P=0.579)。多因素分析显示,肿瘤直径增大、微血管侵犯和肝内转移与根治性肝切除后肿瘤复发相关。
对于非肝硬化肝脏患者,NBNC-HCC 的临床结局与 HBV-HCC 相似,根治性肝切除后可获得较好的预后。