Annals of Surgical Oncology

, Volume 21, Issue 8, pp 2708–2716 | Cite as

Impact of Viral Hepatitis on Outcomes after Liver Resection for Hepatocellular Carcinoma: Results from a North American Center

  • Jonghun J. Lee
  • Peter T. W. Kim
  • Sandra Fischer
  • Scott Fung
  • Steven Gallinger
  • Ian McGilvray
  • Carol-anne Moulton
  • Alice C. Wei
  • Paul D. Greig
  • Sean P. Cleary
Hepatobiliary Tumors



Hepatitis B (HBV) and hepatitis C (HCV) are well-recognized risk factors for hepatocellular carcinoma (HCC). The characteristics and clinical outcomes of HCC arising from these conditions may differ. This study was conducted to compare the outcomes of HCC associated with HBV and HCV after liver resection.


Of 386 liver resections for HCC performed between July 1992 and April 2011, 181 patients had HBV and 74 patients had HCV. Patients with HBV/HCV coinfections (n = 20), non-HBV/HCV etiology (n = 94), and postoperative death within 3 months (n = 17) were excluded. Patient, tumor characteristics, and perioperative and oncologic outcomes were compared between patients with HBV and HCV.


The patients with HBV had better overall survival (OS) than patients with HCV (68 vs. 59 months, p = 0.03); however, there was no difference in recurrence-free survival (RFS) between the groups (44 vs. 45 months, p = 0.1). The factors predictive of OS based on multivariate analyses included: vascular invasion [p < 0.01, hazard ratio (HR) = 3.4], Child-Pugh Score (p < 0.01, HR = 4.8), and underlying liver disease (HCV vs HBV) (p = 0.01, HR = 1.9). Vascular invasion and tumor number (p < 0.01, HR = 2.3 and p < 0.01, HR = 2.1) were independent predictors of RFS.


OS but not RFS after liver resection for HCC is better in patients with HBV than HCV. This survival advantage for HBV patients may be due to differences in tumor biology and outcomes after disease recurrence.


Overall Survival Liver Resection Vascular Invasion Good Overall Survival Hepatic Venous Pressure Gradient 
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.


Conflict of Interest

The authors declare no conflict of interest.


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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Jonghun J. Lee
    • 1
  • Peter T. W. Kim
    • 4
  • Sandra Fischer
    • 2
  • Scott Fung
    • 3
  • Steven Gallinger
    • 1
  • Ian McGilvray
    • 1
  • Carol-anne Moulton
    • 1
  • Alice C. Wei
    • 1
  • Paul D. Greig
    • 1
  • Sean P. Cleary
    • 1
  1. 1.Department of Surgery, 10EN216 Toronto General HospitalUniversity Health Network, University of TorontoTorontoCanada
  2. 2.Department of PathologyUniversity Health Network, University of TorontoTorontoCanada
  3. 3.Department of GastroenterologyUniversity Health Network, University of TorontoTorontoCanada
  4. 4.Abdominal Transplantation and Hepatobiliary SurgeryBaylor University Medical CenterDallasUSA

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