title: Prognostic factors and longterm survival after hepatic resection for hepatocellular carcinoma originating from noncirrhotic liver.
abstract: BACKGROUND
  The incidence of hepatocellular carcinoma (HCC) in cirrhotic and noncirrhotic liver is increasing in the world, probably because of the high prevalence of infections by hepatitis B and C viruses. Despite numerous publications on hepatic resection, prognostic factors for intrahepatic recurrence and survival are not well known for patients with HCC without cirrhosis.
  
  
  METHODS
  One hundred eight consecutive patients with HCC in noncirrhotic liver have been treated by hepatic resection in the past 18 years in our center. Clinical, biologic, and histopathologic parameters of these patients were collected. Risk factors for intrahepatic recurrence and prognostic factors for survival were evaluated by univariate and multivariate analyses.
  
  
  RESULTS
  Postoperative morbidity and mortality rates were 23% and 6.5%, respectively. The 3- and 5-year disease-free and overall survival rates were 55% and 43%, and 43% and 29%, respectively. Blood transfusion, absence of tumor capsule, and daughter nodules were independently associated with overall survival. But the only risk factors for recurrence were blood transfusion, absence of tumor capsule, daughter nodules, and margin resection < 10 mm.
  
  
  CONCLUSIONS
  In the treatment of HCC without cirrhosis, hepatectomy remains a safe and legitimate treatment, but longterm results are impaired by a high rate of early recurrence likely related to metastatic dissemination. Only histopathologic factors related to the tumor are predictive of recurrence and overall survival.
authors.affiliation: Department of Surgery, Saint-Andre Hospital, Bordeaux, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Laurent
authors.forename: Jean Frédéric
authors.initials: JF
authors.lastname: Blanc
authors.forename: Steeve
authors.initials: S
authors.lastname: Nobili
authors.forename: Antonio
authors.initials: A
authors.lastname: Sa Cunha
authors.forename: Brigitte
authors.initials: B
authors.lastname: le Bail
authors.forename: Paulette
authors.initials: P
authors.lastname: Bioulac-Sage
authors.forename: Charles
authors.initials: C
authors.lastname: Balabaud
authors.forename: Maylis
authors.initials: M
authors.lastname: Capdepont
authors.forename: Jean
authors.initials: J
authors.lastname: Saric
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000401:mortality*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis