title: Prognostic factors and outcomes of patients with hepatocellular carcinoma in non-cirrhotic liver.
abstract: OBJECTIVE
  To report the outcome of patients with hepatocellular carcinoma (HCC) in non-cirrhotic liver depending on the mode of primary treatment and to define clinicopathological factors influencing patients' prognosis.
  
  
  METHODS
  A retrospective analysis of an unselected cohort of 105 patients was performed. Overall survival (OS) was estimated by the Kaplan-Meier method and potentially prognostic factors were analyzed in Cox regression models.
  
  
  RESULTS
  OS of the whole cohort at 1, 3, and 5 years was 66%, 47%, and 29%, respectively. Tobacco consumption, ECOG >0, macroscopic vascular invasion, continuous tumor diameter, and treatment other than resection were predictors of decreased OS in the whole cohort. Resection was performed in 64% of patients with 1-, 3-, and 5-year OS rates of 84%, 69%, and 42%, respectively. Siderosis and BCLC stage were associated with decreased OS after resection. Recurrence occurred in 57% of patients with 1-, 3-, and 5-year disease-free survival (DFS) rates of 63%, 39%, and 31%, respectively. Viral hepatitis and macroscopic vascular invasion were associated with decreased DFS. One-, 3-, and 5-year OS rates in patients with non-surgical approaches (transarterial chemoembolization, systemic therapy, best supportive care) were 38%, 11%, and 7%, respectively. Tobacco consumption and Okuda stage were associated with decreased OS in these patients.
  
  
  CONCLUSIONS
  OS and DFS of patients with HCC in non-cirrhotic liver depend most notably on tumor-related, demographic, and etiological factors. Features of the non-neoplastic liver tissue play only a minor role. Liver resection leads to a significantly better prognosis than non-surgical treatment approaches.
authors.affiliation: Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg University, Mainz, Germany. woerns@uni-mainz.de
authors.forename: Marcus A
authors.initials: MA
authors.lastname: Wörns
authors.forename: Timon
authors.initials: T
authors.lastname: Bosslet
authors.forename: Anja
authors.initials: A
authors.lastname: Victor
authors.forename: Sandra
authors.initials: S
authors.lastname: Koch
authors.forename: Maria
authors.initials: M
authors.lastname: Hoppe-Lotichius
authors.forename: Michael
authors.initials: M
authors.lastname: Heise
authors.forename: Torsten
authors.initials: T
authors.lastname: Hansen
authors.forename: Michael B
authors.initials: MB
authors.lastname: Pitton
authors.forename: Ina M
authors.initials: IM
authors.lastname: Niederle
authors.forename: Marcus
authors.initials: M
authors.lastname: Schuchmann
authors.forename: Arndt
authors.initials: A
authors.lastname: Weinmann
authors.forename: Christoph
authors.initials: C
authors.lastname: Düber
authors.forename: Peter R
authors.initials: PR
authors.lastname: Galle
authors.forename: Gerd
authors.initials: G
authors.lastname: Otto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000473:pathology* / Q000601:surgery; D008103:Liver Cirrhosis; D008113:Liver Neoplasms / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents