A comparison of the surgical outcomes among patients with HBV-positive, HCV-positive, and non-B non-C hepatocellular carcinoma: A nationwide study of 11,950 patients

Tohru Utsunomiya, Mitsuo Shimada, Masatoshi Kudo, Takafumi Ichida, Osamu Matsui, Namiki Izumi, Yutaka Matsuyama, Michiie Sakamoto, Osamu Nakashima, Yonson Ku, Tadatoshi Takayama, Norihiro Kokudo

Research output: Contribution to journalArticlepeer-review

69 Citations (Scopus)

Abstract

Objective: To compare the prognostic factors and outcomes after hepatic resection among patients with hepatitis B virus (HBV)-positive, hepatitis C virus (HCV)-positive, and negative for hepatitisBsurface antigen and hepatitis Cantibody, so-called "NBNC"-hepatocellular carcinoma (HCC) using the data from a nationwide survey. Background: The incidence of NBNC-HCC is rapidly increasing in Japan. Methods: A total of 11,950 patients with HBV-HCC (n = 2194), HCV-HCC (n = 7018), or NBNC-HCC (n = 2738) who underwent a curative hepatic resection were enrolled in this study. The clinicopathological features were compared among the groups. The significant prognostic variables determined by univariate analysis were subjected to a multivariate analysis using a Cox proportional hazard regression model. Results: Liver function in the HCV-HCC group was significantly worse than that in the HBV-HCC and NBNC-HCC groups. The NBNC-HCC group had significantly more advanced HCC than the HCV-HCC group. The 5-year overall survival rates after hepatectomy in the HBV-HCC, HCV-HCC, and NBNCHCC groups were 65%, 59%, and 68%, respectively. The 5-year recurrencefree survival (RFS) rates in these 3 groups were 41%, 31%, and 47%, respectively. Stratifying the RFS rates according to the TNM stage showed that the NBNC-HCC group had a significantly better prognosis than the HBVHCC group in stages II, III, and IVA, and a significantly better prognosis than the HCV-HCC group in stages I and II. Multivariate analysis revealed a significantly better RFS rate in the NBNC-HCC group. Conclusions: The findings of this nationwide survey indicated that patients with NBNC-HCC had a significantly lower risk of HCC recurrence than those with HBV-HCC and HCV-HCC.

Original languageEnglish
Pages (from-to)513-520
Number of pages8
JournalAnnals of surgery
Volume261
Issue number3
DOIs
Publication statusPublished - 2015

Keywords

  • Hepatic resection
  • Nationwide study
  • Non-B non-C hepatocellular carcinoma
  • Prognosis

ASJC Scopus subject areas

  • Surgery

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