title: Long-term prognosis after resection of cryptogenic hepatocellular carcinoma.
abstract: BACKGROUND
  We investigated the patterns and predictors of recurrence and survival in cryptogenic non-B, non-C, non-alcoholic hepatocellular carcinoma (CR-HCC). We compared the findings with those hepatitis virus B (B) and hepatitis virus C (C)-HCC. CR-HCC does not include HCC developed on NASH.
  
  
  METHODS
  From 1990 to 2011, of 676 patients who underwent primary curative liver resection as initial therapy for HCC at our institution, 167 had B-HCC, 401 had C-HCC, and 62 had CR-HCC. Differences between three groups were analyzed using the Chi-squared test. Cumulative overall survival (OS) and disease-free survival (DFS) were determined by the Kaplan-Meier method, prognostic factors involved in OS/DFS were evaluated by univariate analysis using the log-rank test, and stepwise Cox regression analysis.
  
  
  RESULTS
  Liver function was better in CR-HCC than in B/C-HCC, and mean tumor size was larger in CR-HCC than in B/C-HCC. In CR-HCC, OS was equivalent to that of B/C-HCC, and DFS was equivalent to that of B-HCC. Both tumor-related factors and background liver function appeared to be prognostic factors for three groups.
  
  
  CONCLUSIONS
  Our findings indicate that the probability of survival of advanced CR-HCC was not longer than that of B/C-HCC. Given our findings, a postoperative follow-up protocol for CR-HCC should be established alongside that for B/C-HCC.
authors.affiliation: Departments of Gastroenterological Surgery, Hepato Pancreato Billiary Surgery Unit, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan. yu.ohkura107@gmail.com.
authors.forename: Yu
authors.initials: Y
authors.lastname: Ohkura
authors.affiliation: Departments of Gastroenterological Surgery, Hepato Pancreato Billiary Surgery Unit, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan. k.sasaki@toranomon.co.jp.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Sasaki
authors.affiliation: Departments of Gastroenterological Surgery, Hepato Pancreato Billiary Surgery Unit, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan. m.matsuda@toranomon.co.jp.
authors.forename: Masamichi
authors.initials: M
authors.lastname: Matsuda
authors.affiliation: Departments of Gastroenterological Surgery, Hepato Pancreato Billiary Surgery Unit, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan. m-masaji@toranommon.co.jp.
authors.forename: Masaji
authors.initials: M
authors.lastname: Hashimoto
authors.affiliation: Departments of Gastroenterological Surgery, Hepato Pancreato Billiary Surgery Unit, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan. g-watanabe@toranomon.co.jp.
authors.forename: Goro
authors.initials: G
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors