Journal of Gastroenterology

, Volume 51, Issue 7, pp 722–732 | Cite as

Distinguished prognosis after hepatectomy of HBV-related hepatocellular carcinoma with or without cirrhosis: a long-term follow-up analysis

  • Sheng-li Yang
  • Li-ping Liu
  • Yun-fan Sun
  • Xing-rong Yang
  • Jia Fan
  • Jian-wei Ren
  • George G. Chen
  • Paul B. S. Lai
Original Article—Liver, Pancreas, and Biliary Tract



Conflicting results have often been observed for the prognosis of hepatocellular carcinoma (HCC) patients, but few studies have attempted to explore the reasons for the conflicting results. We aimed to distinguish the prognosis of patients with HCC with cirrhosis (HCC-C) and that of patients with HCC without cirrhosis (HCC-NC).


Patients with hepatitis B virus (HBV)-associated HCC treated by curative liver resection at a single institution between 1995 and 2013 were retrospectively evaluated. Kaplan–Meier and multivariate analyses were performed to identify risk factors, including tumor-related factors, hypoxia-inducible factor 1α expression, HBV X protein (HBx) expression, and HBx double mutations for overall survival and recurrence-free survival in these patients.


The long-term prognosis of HCC-NC patients is better than that of HCC-C patients. Male sex, poor differentiation, preoperative serum alanine aminotransferase level greater than 80 IU/L, and α-fetoprotein level greater than 400 ng/mL were risk factors for overall survival among HCC-NC patients but not among HCC-C patients, and age greater than 50 years was associated with poor overall survival only in cirrhotic patients. HCC-C patients benefit more from antiviral therapy following curative hepatectomy than do HCC-NC patients. The clinical value of the biomarkers hypoxia-inducible factor 1α, HBx, and HBx double mutations for predicting HCC prognosis was significantly different between these two groups.


There were differences in tumor-related prognostic factors, effectiveness of the antiviral therapy after hepatectomy, and biomarkers between HCC-C and HCC-NC patients, indicating that subgroup analysis of the prognostic factors may result in better management of HCC and that HCC patients, especially those with liver cirrhosis, should be given antiviral therapy.


Hepatocellular carcinoma Cirrhosis Hepatectomy Prognosis Biomarkers Antiviral therapy 



We thank Rocky Ho and Ernest Chak for excellent technical assistance. This study was supported by SRFDP and RGC ERG Joint Research (no. M-CUHK406/13) and the National Natural Science Foundation of China (no. 81472339 and no. 81402041).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

535_2015_1146_MOESM1_ESM.pdf (2.7 mb)
Supplementary material 1 (PDF 2748 kb)


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Copyright information

© Japanese Society of Gastroenterology 2015

Authors and Affiliations

  • Sheng-li Yang
    • 1
  • Li-ping Liu
    • 2
  • Yun-fan Sun
    • 3
  • Xing-rong Yang
    • 3
  • Jia Fan
    • 3
  • Jian-wei Ren
    • 1
  • George G. Chen
    • 1
  • Paul B. S. Lai
    • 1
  1. 1.Department of SurgeryThe Chinese University of Hong Kong, Prince of Wales HospitalShatinChina
  2. 2.Department of Hepatobiliary and Pancreas SurgeryThe Second Clinical Medical College of Jinan University (Shenzhen People’s Hospital)ShenzhenChina
  3. 3.Department of Liver Surgery, Zhongshan Hospital, Liver Cancer InstituteFudan UniversityShanghaiChina

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