title: [Descriptive study of hepatocellular carcinoma in noncirrhotic liver].
abstract: OBJECTIVE
  Hepatocellular carcinoma (HCC) is the sixth leading cause of cancer. In western countries its impact is steadily growing and most of these tumors arise in cirrhotic liver. The aim of this study was to evaluate the incidence and characteristics of HCC developing in noncirrhotic patients.
  
  
  METHODS
  We conducted a retrospective review of 469 patients diagnosed with HCC between January 2003 and December 2007. Patients who met the histological criteria, or a combination of clinical, laboratory, imaging and hemodynamic criteria for the absence of cirrhosis were included.
  
  
  RESULTS
  We identified 29 patients with a diagnosis of HCC in non-cirrhotic liver (6.2%). Most (86.2%) were men and the median age was 61.6 (23 - 82) years. The most frequent histology of the liver was mild-moderate liver fibrosis (68.9%) and 62.1% of the patients were asymptomatic at diagnosis. HCC was a solitary nodule in 86.2%, and the median size of the main nodule was 46 (20 - 150) mm. Macroscopic vascular invasion was demonstrated in two patients and bone metastases in a further two patients. Active treatment was provided in 25 patients, consisting of tumoral resection in 15, radiofrequency ablation in six and transarterial chemoembolization in four. The overall cumulative survival at 1, 2 and 3 years was 84.3%, 67.2% and 50.1%, respectively.
  
  
  CONCLUSIONS
  HCC arising in non-cirrhotic liver is uncommon and there is wide tumor extension at diagnosis. Nevertheless, in most patients, treatment with curative intent can be applied, achieving better survival than that expected patients with cirrhosis.
authors.affiliation: Unidad de Digestivo, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España.
authors.forename: Óscar
authors.initials: Ó
authors.lastname: Núñez Martínez
authors.forename: Ana
authors.initials: A
authors.lastname: Matilla Peña
authors.forename: Beatriz
authors.initials: B
authors.lastname: Merino Rodríguez
authors.forename: Antonio
authors.initials: A
authors.lastname: Díaz Sánchez
authors.forename: Arturo
authors.initials: A
authors.lastname: Colón Rodríguez
authors.forename: Enrique
authors.initials: E
authors.lastname: Ramón Botella
authors.forename: Ismael
authors.initials: I
authors.lastname: Yepes Barreto
authors.forename: Marisa
authors.initials: M
authors.lastname: Prieto Martín
authors.forename: José María
authors.initials: JM
authors.lastname: Tellado Rodríguez
authors.forename: Gerardo
authors.initials: G
authors.lastname: Clemente Ricote
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult