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World Journal of Surgery

, Volume 32, Issue 1, pp 104–109 | Cite as

Long-Term Outcome of Liver Resection for Hepatocellular Carcinoma in Noncirrhotic Nonfibrotic Liver with No Viral Hepatitis or Alcohol Abuse

  • Jean Lubrano
  • Emmanuel Huet
  • Basile Tsilividis
  • Arnaud François
  • Odile Goria
  • Ghassan Riachi
  • Michel Scotté
Article

Abstract

Background

Hepatocellular carcinoma (HCC) occurs primarily in cirrhotic liver, with less than 10% occurring in normal liver parenchyma. Limited studies have described the outcome of liver resection in strictly normal liver parenchyma with no cirrhosis, fibrosis, underlying viral hepatitis, alcohol abuse, or dysmetabolic syndrome.

Materials and methods

Between January 1986 and 2005, a total of 321 patients were referred to our institution for HCC. Of these patients, 20 (6.2%) underwent surgery for HCC arising in noncirrhotic nonfibrotic liver parenchyma; they comprise our study group. Pathology examinations were reviewed based on the Chevallier fibrosis score and the Metavir viral score. Pre-, per-, and postoperative data were collected to assess their influence on tumor recurrence and survival.

Results

The median age was 57 years (35–80 years), and 71% patients were male. α-Fetoprotein serum levels were normal in 9 patients. A preoperative diagnosis was made in 14 cases. Morbidity and morality rates were 10% and 5%, respectively. The 1-, 3-, and 5-year survival rates were 85%, 70%, and 64%, respectively; and disease-free survivals at 1, 3, and 5 years were 84%, 66%, and 58%, respectively. Eight patients had a recurrence with a median delay of 15 months (2–70 months). Univariate analysis showed that survival was influenced by preoperative cytolysis, R0 resection, recurrence, and recurrence within 1 year. A multivariate analysis revealed that recurrence and recurrence within 1 year significantly decreased survival. The 1-, 3-, and 5-year survival rates of patients with recurrence were 75%, 37%, and 25%, respectively.

Conclusion

These results for HCC in patients with normal liver parenchyma justify liver resection and underline the differences in outcome of patients with HCC in a cirrhotic liver.

Keywords

Liver Transplantation Liver Resection Viral Hepatitis Liver Parenchyma Cirrhotic Liver 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

The authors thank Richard Medeiros, Rouen University Hospital Medical Editor, for his advice on editing the manuscript.

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Copyright information

© Société Internationale de Chirurgie 2007

Authors and Affiliations

  • Jean Lubrano
    • 1
  • Emmanuel Huet
    • 1
  • Basile Tsilividis
    • 1
  • Arnaud François
    • 2
  • Odile Goria
    • 3
  • Ghassan Riachi
    • 3
  • Michel Scotté
    • 1
    • 4
  1. 1.Department of General and Digestive SurgeryRouen University HospitalRouenFrance
  2. 2.Department of PathologyRouen University HospitalRouenFrance
  3. 3.Department of GastroenterologyRouen University HospitalRouenFrance
  4. 4.INSERM U 519, Rouen University HospitalRouenFrance

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