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Outcomes Following Resection of Hepatocellular Carcinoma in the Absence of Cirrhosis

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Abstract

Background

Hepatocellular carcinoma (HCC) occasionally occurs in non-cirrhotic patients; however, outcomes for these patients are not extensively documented.

Methods

We performed an institutional review of patients without cirrhosis who underwent resection for HCC. Clinical data were evaluated to identify factors impacting recurrence-free survival (RFS) and overall survival (OS).

Results

Forty-two patients underwent hepatectomy for HCC in the absence of cirrhosis over a 10-year period. Median follow-up was 22 months. For the entire cohort, 1-, 3-, and 5-year RFS was 62%, 42%, and 38% and 1-, 3-, and 5-year OS was 78%, 60%, and 49%, respectively. On univariate analysis, RFS was significantly worse for patients with a disrupted/absent tumor capsule (p = 0.027), vascular invasion (p = 0.030), elevated alkaline phosphatase (p = 0.004), and tumor size > 10 cm (p = 0.016). OS was significantly worse for patients with a disrupted/absent tumor capsule (p = 0.044), obesity (p = 0.036), and elevated alkaline phosphatase (p = 0.007) with a trend towards decreased OS for tumor size > 10 cm (p = 0.07).

Conclusions

Patients undergoing resection for HCC in the absence of cirrhosis have fairly high recurrence and modest survival rates. Pre-operative alkaline phosphatase, tumor size, tumor encapsulation, and vascular invasion are important prognostic factors.

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Authors and Affiliations

  1. Department of Surgery, Division of Surgical Oncology, University of Tennessee Health Science Center, 910 Madison Avenue, 3rd Floor, Memphis, TN, 38163, USA

    Richard H. Lewis, Evan S. Glazer, David M. Bittenbinder, Jeremiah L. Deneve, David Shibata, Stephen W. Behrman & Paxton V. Dickson

  2. West Cancer Center, Memphis, TN, USA

    Evan S. Glazer, Jeremiah L. Deneve, David Shibata & Paxton V. Dickson

  3. Memphis Pathology Group, 1211 Union Avenue, Suite 300, Memphis, TN, 38104, USA

    Thomas O’Brien

  4. Transplant Center, Cleveland Clinic Florida-Weston, 2950 Cleveland Clinic Blvd., Weston, FL, 33331, USA

    Jason M. Vanatta

  5. Methodist University Transplant Institute, Sherard Wing, First Floor, 1265 Union Ave., Memphis, TN, 38104, USA

    Sanjaya K. Satapathy

Authors
  1. Richard H. Lewis
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  10. Paxton V. Dickson
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Correspondence to Paxton V. Dickson.

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This study did not receive any funding. No author has any financial conflict of interest. This article represents a retrospective review of an institutional experience and does not contain any studies with human participants performed by any of the authors.

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Lewis, R.H., Glazer, E.S., Bittenbinder, D.M. et al. Outcomes Following Resection of Hepatocellular Carcinoma in the Absence of Cirrhosis. J Gastrointest Canc 50, 808–815 (2019). https://doi.org/10.1007/s12029-018-0152-x

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  • DOI: https://doi.org/10.1007/s12029-018-0152-x

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