title: Surgical Outcomes of Hepatic Resection for Hepatitis B Virus Surface Antigen-Negative and Hepatitis C Virus Antibody-Negative Hepatocellular Carcinoma.
abstract: BACKGROUND
  The incidence of hepatitis B virus surface antigen-negative and hepatitis C virus antibody-negative hepatocellular carcinoma (NBNC-HCC) is gradually increasing.
  
  
  METHODS
  A retrospective cohort study was performed in 694 patients who underwent curative hepatic resection for primary HCC from January 1990 to December 2011.
  
  
  RESULTS
  In the NBNC-HCC group (n = 110), the complication rate of diabetic mellitus (38 %) was significantly higher than that of the B-HCC group (n = 110; 17 %), and their rate of alcohol abuse (38 %) was significantly higher than that of both the B-HCC (26 %) and C-HCC groups (n = 474; 22 %). In the NBNC-HCC group, the tumor diameter (4.5 ± 3.6 cm) was significantly larger than that of the C-HCC group (2.9 ± 1.8 cm), but the rate of histological cirrhosis (37 %) was significantly lower than those of both the B-HCC (67 %) and C-HCC (53 %) groups. There were no significant differences regarding overall and disease-free survival among the three groups. In the NBNC-HCC group, multiple intrahepatic or distant recurrences (25 %) were significantly higher than in the C-HCC group (17 %), and the rate of recurrence more than 2 years after hepatic resection (24 %) was significantly higher than that of the B-HCC group (12 %).
  
  
  CONCLUSIONS
  The surgical outcomes of patients with NBNC-HCC were not significantly different compared with those of the patients with B-HCC or C-HCC. There was a substantial population with late recurrence among the patients with NBNC-HCC after curative hepatic resection, and thus not only long-term follow-up but also the early establishment of preventive methods for HCC recurrence from NBNC-hepatitis are necessary.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan, yamashi@surg2.med.kyushu-u.ac.jp.
authors.forename: Yo-Ichi
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Daisuke
authors.initials: D
authors.lastname: Imai
authors.forename: Yuki
authors.initials: Y
authors.lastname: Bekki
authors.forename: Koichi
authors.initials: K
authors.lastname: Kimura
authors.forename: Yoshiriro
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Nakagawara
authors.forename: Toru
authors.initials: T
authors.lastname: Ikegami
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Yoshizumi
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.forename: Shinichi
authors.initials: S
authors.lastname: Aishima
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000401:mortality / Q000601:surgery* / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000401:mortality*; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality / Q000601:surgery* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies