title: Outcomes after curative treatment for cryptogenic cirrhosis-associated hepatocellular carcinoma satisfying the Milan criteria.
abstract: OBJECTIVE
  The prognosis of cryptogenic cirrhosis-associated hepatocellular carcinoma (CC-HCC) was reported to be poor because many of them were discovered at the advanced stage. The aim of this study is to reveal the clinical features of early CC-HCC.
  
  
  METHODS
  Consecutive 36 curatively treated CC-HCC patients satisfying the Milan Criteria were compared with corresponding 211 HCV-associated HCC (HCV-HCC) patients. The clinical background, tumor recurrence rate, overall survival rate, and prognostic values of the patients were assessed.
  
  
  RESULTS
  The size of CC-HCCs was larger than that of HCV-HCCs (P = 0.01). The respective tumor recurrence rates at 1, 3, and 5 years were 11%, 32%, and 46% in the CC-HCC, and 21%, 59%, and 81% in the HCV-HCC. The respective overall survival rates at 1, 3, and 5 years were 94%, 85%, and 80% in the CC-HCC, and 98%, 81%, and 61% in the HCV-HCC. CC-HCC patients had a lower tumor recurrence rate and a higher survival rate compared to the HCV-HCC patients (P = 0.001 and P = 0.02, respectively). Via multivariate analysis, significant factors for high recurrence rate were number of HCCs (P = 0.02) and serum alpha fetoprotein levels (P = 0.03) in CC-HCC, whereas multiple tumors (P < 0.001), large tumor size (P = 0.01), and high alanine aminotransferase (P = 0.04) in HCV-HCC. The factor for survival was albumin in both groups.
  
  
  CONCLUSIONS
  The size of CC-HCC was larger than that of HCV-HCC even in patients who received curative treatment; however, the risk for recurrence and the mortality of the patients with CC-HCC was lower than those with HCV-HCC.
authors: Department of Internal Medicine, National Hospital Organization Iwakuni Clinical Center, Yamaguchi, Japan. takuma@enjoy.ne.jp
authors: Yoshitaka
authors: Y
authors: Takuma
authors: Kazuhiro
authors: K
authors: Nouso
authors: Yasuhiro
authors: Y
authors: Makino
authors: Tomoyuki
authors: T
authors: Gotoh
authors: Nobuyuki
authors: N
authors: Toshikuni
authors: Youichi
authors: Y
authors: Morimoto
authors: Hiroyuki
authors: H
authors: Shimomura
authors: Hiroshi
authors: H
authors: Yamamoto
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D005234:Fatty Liver / Q000150:complications*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000209:etiology*; D008113:Liver Neoplasms / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D009364:Neoplasm Recurrence, Local; D065626:Non-alcoholic Fatty Liver Disease; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome