title: Outcomes of hepatectomy for noncirrhotic hepatocellular carcinoma: a systematic review.
abstract: BACKGROUND
  Noncirrhotic hepatocellular carcinoma (HCC) is rare. The aim of this study was to evaluate the published evidence for hepatectomy in patients with noncirrhotic HCC.
  
  
  METHODS
  A literature search was conducted in PubMed database for eligible studies from the time of inception to March 2014. Comparisons of surgical outcomes for noncirrhotic and cirrhotic HCC were pooled and analyzed by meta-analytical techniques.
  
  
  RESULTS
  Thirty-one observational studies comprising a total of 3771 patients who underwent hepatectomy for noncirrhotic HCC were reviewed. The median postoperative morbidity was 29.5% (range, 8.3-55.5%) and mean mortality was 2.7% (range, 0-6.5%). Median 5-year overall and disease free survival was 47.9% (range, 26-81%) and 38.0% (range, 24.0-58.4%) respectively. In comparative studies, both the 5-year disease free (odds ratio (OR): 0.61, 95% confidence interval (95% CI): 0.51-0.72; P<0.001) and overall survival (OR: 0.61, 95% CI: 0.42-0.90; P=0.01) in the noncirrhotic group were significantly better than those in the cirrhotic group.
  
  
  CONCLUSIONS
  Hepatectomy for noncirrhotic HCC carries low perioperative morbidity and mortality and offers favorable long-term outcomes.
authors.affiliation: Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Oncologic Center of Xiamen, Xiamen, China. Electronic address: zhouymsxy@sina.cn.
authors.forename: Yanming
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Oncologic Center of Xiamen, Xiamen, China.
authors.forename: Xiaoyi
authors.initials: X
authors.lastname: Lei
authors.affiliation: Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Oncologic Center of Xiamen, Xiamen, China.
authors.forename: Lupeng
authors.initials: L
authors.lastname: Wu
authors.affiliation: Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Oncologic Center of Xiamen, Xiamen, China.
authors.forename: Xiurong
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Oncologic Center of Xiamen, Xiamen, China.
authors.forename: Donghui
authors.initials: D
authors.lastname: Xu
authors.affiliation: Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Oncologic Center of Xiamen, Xiamen, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Li
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D018572:Disease-Free Survival; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Hepatectomy; Hepatocellular carcinoma; Non-cirrhotic liver; Prognosis