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Annals of Surgical Oncology

, Volume 21, Issue 2, pp 458–465 | Cite as

Differences Between Hepatocellular Carcinoma and Hepatitis B Virus Infection in Patients With and Without Cirrhosis

  • Jong Man Kim
  • Choon Hyuck David Kwon
  • Jae-Won Joh
  • Jae Berm Park
  • Joon Hyeok Lee
  • Sung Joo Kim
  • Seung Woon Paik
  • Cheol Keun Park
  • Byung Chul Yoo
Hepatobiliary Tumors

Abstract

Background

In patients with hepatitis B virus (HBV) infections, differences in hepatocellular carcinoma (HCC) between those with liver cirrhosis and those without cirrhosis have not been elucidated. The aim of this study was to compare clinicopathological characteristics and survival between noncirrhotic and cirrhotic patients and to determine prognostic factors for tumor recurrence after hepatectomy in patients with HBV and HCC.

Methods

Between 2005 and 2010, 441 curative hepatectomies for HCC in patients with cirrhosis and 454 for HCC in patients without cirrhosis were performed.

Results

Cirrhotic patients had lower platelet counts, protein induced by vitamin K antagonist-II (PIVKA-II) levels, and tumor size than noncirrhotic patients. HCC differentiation in noncirrhotic patients was poorer than in cirrhotic patients. The 1-, 2-, and 3-year disease-free survival rates were 72.0, 65.6, and 61.0 % in noncirrhotic patients, and 68.6, 56.5, and 51.5 % in cirrhotic patients, respectively (P = 0.013). However, the 1-, 2-, and 3-year overall survival rates were 92.4, 85.5, and 81.7 % in noncirrhotic patients, and 91.9, 86.1, and 82.4 % in cirrhotic patients, respectively (P = 0.683). Risk factors for tumor recurrence in each group varied in multivariate analyses. Increased age, high platelet counts, microvascular invasion, serosal invasion, and intrahepatic metastasis predisposed to tumor recurrence in noncirrhotic patients, but elevated PIVKA-II and alkaline phosphatase levels, low serum albumin levels, portal vein invasion, intrahepatic metastasis, and tumor size were predisposing factors for recurrence in cirrhotic patients.

Conclusions

The clinicopathologic characteristics and risk factors for tumor recurrence in cirrhotic and noncirrhotic HCC patients with HBV infection differ.

Keywords

Cirrhotic Patient Intrahepatic Metastasis Intrahepatic Recurrence Microvascular Invasion Serosal Invasion 
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

Acknowledgment

The authors have no affiliations with or financial involvement in any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. Writing assistance was used in the production of this manuscript.

Disclosure

The authors have no conflicts of interest to disclose.

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Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Jong Man Kim
    • 1
  • Choon Hyuck David Kwon
    • 1
  • Jae-Won Joh
    • 1
  • Jae Berm Park
    • 1
  • Joon Hyeok Lee
    • 2
  • Sung Joo Kim
    • 1
  • Seung Woon Paik
    • 2
  • Cheol Keun Park
    • 3
  • Byung Chul Yoo
    • 2
  1. 1.Department of Surgery, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea
  2. 2.Division of Gastroenterology, Department of Medicine, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea
  3. 3.Department of Pathology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea

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