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

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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

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Hepatitis B virus
Hepacivirus
Hepatocellular Carcinoma
Survival Rate
Liver
Multivariate Analysis
Hepatitis Antigens
Hepatectomy
Proportional Hazards Models

Keywords

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

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

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

In: Annals of Surgery, Vol. 261, No. 3, 2015, p. 513-520.

Research output: Contribution to journalArticle

Utsunomiya, T, Shimada, M, Kudo, M, Ichida, T, Matsui, O, Izumi, N, Matsuyama, Y, Sakamoto, M, Nakashima, O, Ku, Y, Takayama, T & Kokudo, N 2015, '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', Annals of Surgery, vol. 261, no. 3, pp. 513-520. https://doi.org/10.1097/SLA.0000000000000821
Utsunomiya, Tohru ; Shimada, Mitsuo ; Kudo, Masatoshi ; Ichida, Takafumi ; Matsui, Osamu ; Izumi, Namiki ; Matsuyama, Yutaka ; Sakamoto, Michiie ; Nakashima, Osamu ; Ku, Yonson ; Takayama, Tadatoshi ; Kokudo, Norihiro. / 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. In: Annals of Surgery. 2015 ; Vol. 261, No. 3. pp. 513-520.
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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.",
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T1 - A comparison of the surgical outcomes among patients with HBV-positive, HCV-positive, and non-B non-C hepatocellular carcinoma

T2 - A nationwide study of 11,950 patients

AU - Utsunomiya, Tohru

AU - Shimada, Mitsuo

AU - Kudo, Masatoshi

AU - Ichida, Takafumi

AU - Matsui, Osamu

AU - Izumi, Namiki

AU - Matsuyama, Yutaka

AU - Sakamoto, Michiie

AU - Nakashima, Osamu

AU - Ku, Yonson

AU - Takayama, Tadatoshi

AU - Kokudo, Norihiro

PY - 2015

Y1 - 2015

N2 - 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.

AB - 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.

KW - Hepatic resection

KW - Nationwide study

KW - Non-B non-C hepatocellular carcinoma

KW - Prognosis

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