title: Viral hepatitis status does not affect survival in patients with hepatocellular carcinoma.
abstract: BACKGROUND
  There have been few studies on the impact of viral etiology on the prognosis in patients with hepatocellular carcinoma (HCC). The aim of this study was to evaluate the clinical characteristics and survival of patients with viral hepatitis-associated HCC (V-HCC), compared to patients with HCC of non-hepatitis B, non-hepatitis C (NBNC-HCC) etiology.
  
  
  METHODS
  We performed a retrospective analysis of all patients with HCC treated at our comprehensive cancer center from 2000 through 2014. Patients were divided into two groups according to their viral hepatitis status. Presentation patterns, treatments, and survival data were analyzed.
  
  
  RESULTS
  We evaluated 366 patients: 233 patients (63.7%) had V-HCC while 133 (36.3%) patients had NBNC-HCC. V-HCC patients were younger (P<0.0001) and more likely to be male (P=0.001). Decompensated cirrhosis was more prevalent in V-HCC patients (P=0.01). There was no difference in the resectability rate or disease stage. In patients with resectable disease, those with V-HCC were less likely to undergo hepatectomy (23.7% vs. 38%; P=0.04) for more advanced liver disease. The estimated median survival for V-HCC was 13 months compared to 16 months in NBNC-HCC patients (P=0.57). On multivariate analysis, disease stage (P<0.0001) and Child-Pugh class (P<0.0001) were independent factors affecting survival, but viral status was not (P=0.75).
  
  
  CONCLUSIONS
  Despite presenting with more advanced cirrhosis and being less likely to undergo surgery, V-HCC patients had similar survival to patients with NBNC-HCC.
authors.affiliation: Department of Surgery, School of Medicine, University of New Mexico, New Mexico, USA.
authors.forename: Eyas
authors.initials: E
authors.lastname: Alkhalili
authors.affiliation: Department of Surgery, School of Medicine, University of New Mexico, New Mexico, USA.
authors.forename: Alissa
authors.initials: A
authors.lastname: Greenbaum
authors.affiliation: Department of Surgery, School of Medicine, University of New Mexico, New Mexico, USA.
authors.forename: Li
authors.initials: L
authors.lastname: Luo
authors.affiliation: Department of Surgery, School of Medicine, University of New Mexico, New Mexico, USA.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Rodriguez
authors.affiliation: Department of Surgery, School of Medicine, University of New Mexico, New Mexico, USA.
authors.forename: Katharine
authors.initials: K
authors.lastname: Caldwell
authors.affiliation: Department of Surgery, School of Medicine, University of New Mexico, New Mexico, USA.
authors.forename: Oscar Munoz
authors.initials: OM
authors.lastname: Estrada
authors.affiliation: Department of Surgery, School of Medicine, University of New Mexico, New Mexico, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: O'Neill
authors.affiliation: Department of Surgery, School of Medicine, University of New Mexico, New Mexico, USA.
authors.forename: Itzhak
authors.initials: I
authors.lastname: Nir
authors.affiliation: Department of Surgery, School of Medicine, University of New Mexico, New Mexico, USA.
authors.forename: Katherine T
authors.initials: KT
authors.lastname: Morris
keywords: Hepatocellular carcinoma; survival; viral hepatitis