title: Recurrence of hepatocellular carcinoma in noncirrhotic liver after hepatectomy.
abstract: BACKGROUND
  Hepatocellular carcinoma in noncirrhotic liver (HCCNC) is rare. This tumor has a particular epidemiology and presentation, and it requires specific treatment, compared with HCC in cirrhotic liver. The aims of this study were to determine the survival and recurrence rates, prognostic factors, and optimum treatment of HCCNC and to propose a follow-up protocol for patients who have undergone surgery for HCCNC.
  
  
  METHODS
  This study included 131 patients who underwent surgical treatment for HCCNC from January 1992 to December 2010. Survival and recurrence rates were evaluated, and the prognostic factors and characteristics of recurrence were analyzed. Pathologic characteristics of the tumors and the nontumoral liver were examined.
  
  
  RESULTS
  The mean survival time was 67.9 months. The 5- and 10-year overall survival rates were 72.9 and 36.7 %, respectively. In all, 54 patients (41.2 %) developed recurrence at a median interval of 30.96 months. Of these recurrences, 31.5 % occurred during the first year, and 24.1 % occurred more than 5 years after surgery. Macro- or microvascular invasion and tumor size >5 cm were significantly associated with a poor survival rate. The predictive factors for recurrence were multiple tumors, tumor diameter >5 cm, and satellite nodules. Patients who underwent surgical treatment for recurrence had a significantly longer survival time than those who did not (p < 0.0292).
  
  
  CONCLUSIONS
  Recurrence is the most common cause of death after hepatectomy for HCC, and patients should undergo careful, long-term follow-up. Early detection and treatment of recurrence with curative intent should improve the prognosis of these patients.
authors.affiliation: Department of Digestive Surgery, CHU de Bordeaux, Maison du Haut Lévèque, Avenue de Magellan, 33604 Pessac Cedex, France. laurence.chiche@chu-bordeaux.fr
authors.forename: Laurence
authors.initials: L
authors.lastname: Chiche
authors.forename: B
authors.initials: B
authors.lastname: Menahem
authors.forename: C
authors.initials: C
authors.lastname: Bazille
authors.forename: V
authors.initials: V
authors.lastname: Bouvier
authors.forename: L
authors.initials: L
authors.lastname: Plard
authors.forename: V
authors.initials: V
authors.lastname: Saguet
authors.forename: A
authors.initials: A
authors.lastname: Alves
authors.forename: E
authors.initials: E
authors.lastname: Salame
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002985:Clinical Protocols; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000473:pathology* / Q000601:surgery; D008103:Liver Cirrhosis / Q000150:complications / Q000473:pathology; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome