Ann Surg Treat Res.  2022 Jan;102(1):1-9. 10.4174/astr.2022.102.1.1.

Hepatectomy outcomes in patients with hepatitis C virusrelated hepatocellular carcinoma with or without cirrhosis

• Kim JM
• Rhu J
• Ha SY
• Choi GS
• David Kwon CH
• Joh JW

• KMID: 2523764
• DOI: http://doi.org/10.4174/astr.2022.102.1.1

Abstract

Purpose
Hepatocellular carcinoma (HCC) is rare in HCV patients without cirrhosis, and little is known about the postoperative results of these patients. The present study compares the outcomes of cirrhotic and non-cirrhotic groups after liver resection (LR) in solitary HCV-related HCC patients and identifies risk factors for prognosis according to the presence or absence of cirrhosis in these patients.
Methods
Two hundred and 7 adult hepatectomy patients with treatment-naïve solitary HCV-related HCC were identified prospectively at our institution between July 2005 and May 2019.
Results
The non-cirrhotic group had better liver function than the cirrhotic group based on platelet count, liver function tests, liver stiffness measurement, and indocyanine green retention rate at 15 minutes but were older than the cirrhotic group. Consistently, noninvasive markers in the cirrhotic group were significantly higher than in the non-cirrhotic group. The cumulative disease-free survival and overall survival in the non-cirrhotic group were significantly higher than in the cirrhotic group. HCC recurrence was related to major LR and α-FP of >40 ng/mL and death was related to long hospitalization and α-FP of >40 ng/mL in multivariate analysis. Noninvasive markers and the presence of cirrhosis were not related to HCC recurrence or death in multivariate analyses.
Conclusion
The cirrhotic group showed poor prognosis due to poor liver function after LR compared to the non-cirrhotic group, but this was not sustained in multivariate analysis. The factors influencing HCC recurrence and death were different in the cirrhotic and non-cirrhotic groups.

Keyword

Biomarker; Hepacivirus; Hepatectomy; Treatment outcome

Figure

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  Fig. 1 Disease-free survival (DFS) in non-cirrhotic and cirrhotic groups of HCV-related hepatocellular carcinoma (HCC).

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  Fig. 2 Overall survival (OS) in non-cirrhotic and cirrhotic groups of HCV-related hepatocellular carcinoma.

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  Fig. 3 Hepatocellular carcinoma (HCC) recurrence according to noninvasive markers. (A) Fibrosis-4 (FIB-4) index, (B) AST-to-platelet ratio index (APRI), and (C) albumin-bilirubin (ALBI) grade. DFS, disease-free survival.

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  Fig. 4 Overall survival (OS) according to noninvasive markers. (A) Fibrosis-4 (FIB-4) index, (B) AST-to-platelet ratio index (APRI), and (C) albumin-bilirubin (ALBI) grade.

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