Hepatocellular carcinoma in non-cirrhotic liver: a reappraisal.
Although not frequently, hepatocellular carcinoma (HCC) can ensue in a non-cirrhotic liver. As compared to cirrhotic HCC, this kind of tumour has some peculiarities, such as: (a) a lower male preponderance and a bimodal age distribution; (b) a lower prevalence of the three main risk factors (hepatitis B and C virus infections and alcohol abuse), with an increased prevalence of other etiologic factors, such as exposure to genotoxic substances and sex hormones, inherited diseases, genetic mutations; (c) a more advanced tumour stage at the time of diagnosis, as it is usually detected due to the occurrence of cancer-related symptoms, outside any scheduled surveillance program; (d) a much higher amenability to hepatic resection, due to the low risk of liver failure even after extended parenchymal mutilation; (e) overall and disease-free survivals after resection of non-advanced tumours (meeting the Milano criteria) comparable to that obtained with liver transplantation in cirrhotic patients carrying an early tumour; (f) overall survival strictly dependent on tumour burden (and its recurrence) and barely influenced by liver function.
Trevisani
Franco
F
Dipartimento di Medicina Clinica, Semeiotica Medica, Alma Mater Studiorum - Università di Bologna, 40138 Bologna, Italy. franco.trevisani@unibo.it
Frigerio
Marta
M
Santi
Valentina
V
Grignaschi
Alice
A
Bernardi
Mauro
M
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000150:complications; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery / Q000821:virology*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006525:Hepatitis, Viral, Human / Q000150:complications*; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery / Q000821:virology*; D008297:Male; D008875:Middle Aged; D011287:Prejudice; D055815:Young Adult