title: Tumour size and differentiation predict survival after liver resection for hepatocellular carcinoma arising from non-cirrhotic and non-fibrotic liver: a case-controlled study.
abstract: OBJECTIVE
  The aims of this study were to assess the outcomes of patients who underwent potentially curative hepatic resection for hepatocellular carcinoma (HCC) in a background of non-cirrhotic/non-fibrotic livers, and to determine prognostic factors that influenced survival.
  
  
  METHODS
  Over a 15-year period, all patients undergoing hepatectomy for HCC were identified. Collated data included demographics, laboratory analysis, operative findings and histo-pathological data. Survival differences between these factors following liver resection were determined.
  
  
  RESULTS
  57 patients were included with a median age of 70 years. The majority of patients underwent a hemi-hepatectomy or more radical resection (n = 37). Overall R0 resection rate was 90.4% (n = 51). The overall morbidity and mortality rates were 26.3% and 3.5%, respectively. The median follow-up period was 28 months. The 1-, 3- and 5- year disease-free survival was 65.4%, 41.8% and 39.1%, and the overall survival was 73.5%, 49.6% and 39.5%, respectively. AFP (p = 0.039) was the only predictor of poorer disease-free survival on univariate analysis. On multi-variable analysis, poorly differentiated tumour and large tumour size were independent predictors of overall survival.
  
  
  CONCLUSIONS
  Liver resection is a feasible treatment option for HCC in non-cirrhotic/non-fibrotic livers with good survival outcome. Tumour size and differentiation are adverse predictors of outcome in these patients.
authors.affiliation: North Western Hepatobiliary Unit, Aintree University Hospital NHS Foundation Trust, Liverpool, UK. Electronic address: vincentyip@doctors.org.uk.
authors.forename: V S
authors.initials: VS
authors.lastname: Yip
authors.forename: D
authors.initials: D
authors.lastname: Gomez
authors.forename: C Y
authors.initials: CY
authors.lastname: Tan
authors.forename: S
authors.initials: S
authors.lastname: Staettner
authors.forename: M
authors.initials: M
authors.lastname: Terlizzo
authors.forename: S
authors.initials: S
authors.lastname: Fenwick
authors.forename: H Z
authors.initials: HZ
authors.lastname: Malik
authors.forename: P
authors.initials: P
authors.lastname: Ghaneh
authors.forename: G
authors.initials: G
authors.lastname: Poston
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000601:surgery*; D016022:Case-Control Studies; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
keywords: Hepatectomy; Hepatic resection; Hepatocellular carcinoma; Non-cirrhosis; Non-fibrosis