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Fibrosis in Non-cancerous Tissue is the Unique Prognostic Factor for Primary Hepatocellular Carcinoma Without Hepatitis B or C Viral Infection

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Abstract

Background:

The relationship between the state of non-cancerous tissues in patients with hepatocellular carcinoma (HCC) who are negative for hepatitis B surface antigen (HBsAg), hepatitis B core antibody (HBcAb), and hepatitis C antibody (HCVAb) (NBNC-HCC) and the prognosis has not yet been resolved.

Methods:

We examined the clinicopathological features of these patients and performed statistical analysis for the prognosis of recurrence following curative hepatic resection.

Results:

Disease-free survival (DFS) revealed that only the degree of fibrosis was a significant prognostic factor (P = 0.0374). On the basis of the degree of fibrosis (New Inuyama Classification), patients with NBNC-HCC were divided into a non-fibrotic liver group (NF group; F0, n = 10) and a fibrotic liver group (FL group; F1–4, n = 34). The DFS rate in the NF group was significantly better than that in the FL group (P = 0.0408). In the NF group, only one patient recurred, while in the FL group, 21 patients had recurrences. In the FL group, intra-hepatic recurrence was frequently seen in both lobes within 2 years after the initial hepatic resection, while recurrences more than 2 years after the initial operation were mainly seen in the contralateral lobe.

Conclusion:

Histological assessment of the degree of fibrosis in the non-cancerous regions of NBNC-HCC may be useful not only for the selection of the appropriate treatment but also for the prediction of postoperative prognosis.

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References

  1. Kiyosawa K, Umemura T, Ichijo T, et al. Hepatocellular carcinoma: recent trends in Japan. Gastroenterology 2004;127:17–26

    Article  Google Scholar 

  2. Ikeda K, Saitoh S, Koida I, et al. A multivariate analysis of risk factors for hepatocellular carcinogenesis: a prospective observation of 795 patients with viral and alcoholic cirrhosis. Hepatology 1993;18:47–53

    Article  PubMed  CAS  Google Scholar 

  3. Wakai T, Shirai Y, Yokoyama N, et al. Hepatitis viral status affects the pattern of intra-hepatic recurrence after resection for hepatocellular carcinoma. Eur J Surg Oncol 2003;29:266–271

    Article  PubMed  CAS  Google Scholar 

  4. Yamanaka N, Okamoto E, Oriyama T, et al. A prediction scoring system to select the surgical treatment of liver cancer. Further refinement based on 10 years of use. Ann Surg 1994;219:342–346

    PubMed  CAS  Google Scholar 

  5. Yamanaka N, Tanaka T, Tanaka W, et al. Correlation of hepatitis virus serologic status with clinicopathologic features in patients undergoing hepatectomy for hepatocellular carcinoma. Cancer 1997;79:1509–1515

    Article  PubMed  CAS  Google Scholar 

  6. Watabe H, Shiratori Y, Tateishi R, et al. Clinical features of patients with HCC who are negative for both HBV and HCV markers. Hepatogastroenterology 2003;50:2157–2160

    PubMed  Google Scholar 

  7. Lai CL, Lam KC, Wong KP, et al. Clinical features of hepatocellular carcinoma: review of 211 patients in Hong Kong. Cancer 1981;47:2746

    Article  PubMed  CAS  Google Scholar 

  8. Okuda K, Nakashima T, Sakamoto K, et al. Hepatocellular carcinoma arising in noncirrhotic and highly cirrhotic livers: a comparative study of histopathology and frequency of hepatitis B markers. Cancer 1982;49:450–455

    Article  PubMed  CAS  Google Scholar 

  9. Bilimoria MM, Lauwers GY, Doherty DA, et al. International Cooperative Study Group on Hepatocellular Carcinoma. Underlying liver disease, not tumor factors, predicts long-term survival after resection of hepatocellular carcinoma. Arch Surg 2001;136:528–535

    Article  PubMed  CAS  Google Scholar 

  10. Wayne JD, Lauwers GY, Ikai I, et al. Preoperative predictors of survival after resection of small hepatocellular carcinomas. Ann Surg 2002;235:722–730

    Article  PubMed  Google Scholar 

  11. Ko S, Kanehiro H, Hisanaga M, et al. Liver fibrosis increases the risk of intrahepatic recurrence after hepatectomy for hepatocellular carcinoma. Br J Surg 2002;89:57–62

    Article  PubMed  CAS  Google Scholar 

  12. Shimada M, Rikimaru T, Sugimachi K, et al. The importance of hepatic resection for hepatocellular carcinoma originating from nonfibrotic liver. J Am Coll Surg 2000;191:531–537

    Article  PubMed  CAS  Google Scholar 

  13. Greene FL, Page DL, Fleming ID, et al. AJCC (American Joint Committee on Cancer) Cancer staging manual, 6th edn. Springer-Verlag, New York

    Google Scholar 

  14. Ichida F, Tsuji T, Omata M, et al. New Inuyama Classification for histological assessment of chronic hepatitis. Hepatol Commun 1996;6:112–119

    Article  Google Scholar 

  15. Takano S, Yokosuka O, Imazeki F, et al. Incidence of hepatocellular carcinoma in chronic hepatitis B and C: a prospective study of 251 patients. Hepatology 1995;21:650–655

    Article  PubMed  CAS  Google Scholar 

  16. Nzeako UC, Goodman ZD, Ishak KG. Hepatocellular carcinoma in cirrhotic and noncirrhotic livers. A clinico-histopathologic study of 804 North American patients. Am J Clin Pathol 1996;105:65–75

    PubMed  CAS  Google Scholar 

  17. Lauwers GY, Terris B, Balis UJ, et al. International cooperative study group on hepatocellular carcinoma. Prognostic histologic indicators of curatively resected hepatocellular carcinomas: a multi-institutional analysis of 425 patients with definition of a histologic prognostic index. Am J Surg Pathol 2002;26:25–34

    Article  PubMed  Google Scholar 

  18. Adachi E, Maeda T, Kajiyama K, et al. Factors correlated with portal venous invasion by hepatocellular carcinoma: univariate and multivariate analyses of 232 resected cases without preoperative treatments. Cancer 1996;77:2022–2031

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan

    Yoshito Tomimaru MD, Yo Sasaki MD, Terumasa Yamada MD, Hidetoshi Eguchi MD, Hiroaki Ohigashi MD, Osamu Ishikawa MD & Shingi Imaoka MD

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  1. Yoshito Tomimaru MD
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  2. Yo Sasaki MD
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  3. Terumasa Yamada MD
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  4. Hidetoshi Eguchi MD
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  5. Hiroaki Ohigashi MD
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  6. Osamu Ishikawa MD
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  7. Shingi Imaoka MD
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Correspondence to Yo Sasaki MD.

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Tomimaru, Y., Sasaki, Y., Yamada, T. et al. Fibrosis in Non-cancerous Tissue is the Unique Prognostic Factor for Primary Hepatocellular Carcinoma Without Hepatitis B or C Viral Infection. World J. Surg. 30, 1729–1735 (2006). https://doi.org/10.1007/s00268-005-0123-9

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  • DOI: https://doi.org/10.1007/s00268-005-0123-9

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