title: Resection of hepatocellular carcinoma in noncirrhotic liver: analysis of risk factors for survival.
abstract: BACKGROUND
  The aim of this study was to identify factors predictive of survival after curative resection of hepatocellular carcinoma (HCC) in noncirrhotic liver.
  
  
  METHODS
  Eighty-four patients underwent resection of HCC in noncirrhotic liver between January 1998 and December 2003. Univariate and multivariable analyses were used to retrospectively identify factors associated with overall survival and disease-free survival when resection was curative for the primary tumor.
  
  
  RESULTS
  Overall 1-, 3-, and 5-year survival rates were 77.8%, 55.0%, and 44.4%, respectively, and 84.0%, 62.0%, and 50.0% when resection was curative for the primary tumor. HCC recurred in 27 patients (39.1%). Recurrence was intrahepatic in 14 patients (51.9%), extrahepatic in 3 patients (11.1%), and both intra- and extrahepatic in the remaining 10 patients (37.0%). In multivariable analysis, three independent factors were associated with poorer overall survival and recurrence-free survival, namely multiple tumors, macroscopic vascular invasion, and nonuse of adjuvant iodine-131-iodized oil.
  
  
  CONCLUSIONS
  Aggressive operation is an effective treatment for HCC in noncirrhotic patients, whatever the degree of liver fibrosis. Multiple tumors and macroscopic vascular invasion are poor prognostic factors. Postoperative iodine-131-iodized oil injection appears to prevent recurrence and improve overall survival, although this needs to be confirmed in a prospective randomized trial.
authors.affiliation: Centre Hospitalo-Universitaire Pontchaillou, Rennes, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Dupont-Bierre
authors.forename: Philippe
authors.initials: P
authors.lastname: Compagnon
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Raoul
authors.forename: Gabriel
authors.initials: G
authors.lastname: Fayet
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: de Lajarte-Thirouard
authors.forename: Karim
authors.initials: K
authors.lastname: Boudjema
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000401:mortality*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis