Comparative analysis of liver resection in Non-B Non-C and hepatitis virus-associated hepatocellular carcinoma

The incidence of non-hepatitis B and non-hepatitis C hepatocellular carcinoma (NBNC-HCC) is increasing in our country. This study assesses the feasibility of employing an identical surgical treatment strategy for resectable NBNC-HCC as that for hepatitis virus-associated HCC (HV-HCC). A retrospectiv...

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Published in:European journal of surgical oncology 2024-07, Vol.50 (7), p.108381, Article 108381
Main Authors: Takamoto, Takeshi, Nara, Satoshi, Ban, Daisuke, Mizui, Takahiro, Mukai, Masami, Minoru, Esaki, Shimada, Kazuaki
Format: Article
Language:English
Subjects:
Aged
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - surgery
Carcinoma, Hepatocellular - virology
Female
Hepatectomy
Hepatitis virus
Hepatocellular carcinoma
Humans
Liver Neoplasms - pathology
Liver Neoplasms - surgery
Liver Neoplasms - virology
Liver resection
Male
Middle Aged
Non-B non-C
Operative Time
Propensity Score
Retrospective Studies
Survival Rate
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Summary:The incidence of non-hepatitis B and non-hepatitis C hepatocellular carcinoma (NBNC-HCC) is increasing in our country. This study assesses the feasibility of employing an identical surgical treatment strategy for resectable NBNC-HCC as that for hepatitis virus-associated HCC (HV-HCC). A retrospective analysis (1993–2023) of 1321 curative liver resections for HCC at a single institution was performed. Propensity score matching ensured a balanced comparison of preoperative clinical factors, including tumor status and background liver condition. The proportion of NBNC-HCC cases has gradually increased, reaching up to 70 %. After matching, 294 of 473 NBNC-HCC patients and 294 of 848 HV-HCC patients were compared. Operative outcomes, including operation time, blood loss, type of surgical procedure, and morbidity, were comparable. Long-term outcome analysis showed similar recurrence-free survival (HR: 0.86, 95 % CI: 0.70–1.06, P = 0.167) and overall survival (HR: 0.98, 95 % CI: 0.79–1.23, P = 0.865) for NBNC-HCC. Multivariable analysis identified ICGR15 ≥ 15 %, ALBI grade 2 or 3, aspartate aminotransferase ≥40, tumor size > 5 cm, multiple tumors, macrovascular invasion, and microvascular invasion as independent prognostic factors for overall survival, while hepatitis B or C virus status lost significance. Despite the increasing incidence of NBNC-HCC, comparable outcomes were achieved between the two groups of matched cohort.
ISSN:0748-7983
1532-2157
1532-2157
DOI:10.1016/j.ejso.2024.108381