Fibrosis in non-cancerous tissue is the unique prognostic factor for primary hepatocellular carcinoma without hepatitis B or C viral infection.
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.


CONCLUSIONS
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.
Tomimaru
Yoshito
Y
Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, Japan.
Sasaki
Yo
Y
Yamada
Terumasa
T
Eguchi
Hidetoshi
H
Ohigashi
Hiroaki
H
Ishikawa
Osamu
O
Imaoka
Shingi
S
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D016019:Survival Analysis