title: Liver resection for hepatocellular carcinoma in non-cirrhotic liver without underlying viral hepatitis.
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) arising in normal liver parenchyma is rare and the outcome after hepatectomy is not well documented.
  
  
  METHODS
  Between June 1998 and September 2003, 33 patients without viral hepatitis underwent resection for HCC in a non-cirrhotic, non-fibrotic liver. Data were analysed with regard to operative details, pathological findings including completeness of resection, and outcome as measured by tumour recurrence and survival.
  
  
  RESULTS
  Twenty-three major hepatectomies and ten segmentectomies or bisegmentectomies were performed. After potentially curative resection, 19 of 29 patients were alive at a median follow-up of 25 months, with calculated 1- and 3-year survival rates of 87 and 50 per cent respectively. Survival was significantly better after resection of tumours without vascular invasion (3-year survival rate 89 versus 18 per cent; P = 0.024). Disseminated recurrence developed in nine of 29 patients, leading to death within 28 months of operation in all but one of the nine.
  
  
  CONCLUSIONS
  These data justify hepatic resection for HCC arising in non-cirrhotic, non-fibrotic liver without underlying viral hepatitis. Liver transplantation is rarely indicated because the outcome is good after resection of tumours without vascular infiltration, whereas vascular invasion is invariably associated with diffuse extrahepatic recurrence.
authors.affiliation: Klinik für Allgemein- und Transplantationschirurgie, University Hospital Essen, Germany. hauke.lang@uni-essen.de
authors.forename: H
authors.initials: H
authors.lastname: Lang
authors.forename: G C
authors.initials: GC
authors.lastname: Sotiropoulos
authors.forename: M
authors.initials: M
authors.lastname: Dömland
authors.forename: N R
authors.initials: NR
authors.lastname: Frühauf
authors.forename: A
authors.initials: A
authors.lastname: Paul
authors.forename: J
authors.initials: J
authors.lastname: Hüsing
authors.forename: M
authors.initials: M
authors.lastname: Malagó
authors.forename: C E
authors.initials: CE
authors.lastname: Broelsch
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome