Hepatocellular carcinoma occurring in noncirrhotic livers is rare.
Professor Hauke Lang and colleagues from Germany evaluated the outcomes and prognostic factors after hepatectomy.
Between 1998 and 2005, 83 patients underwent liver resection for hepatocellular carcinoma in noncirrhotic livers at the researchers' institution.
Preoperative treatment data, intraoperative details, pathologic findings, and information on tumor recurrence, treatment of recurrence, and survival were available for 80 of these patients.
Postresection, the 3- and 5-year-survival rates were 48% and 30%, respectively.
|For tumors without vascular invasion, the 3-year survival rate was 79%|
|Journal of the American College of Surgeons|
After R0 resection in 66 patients, the calculated 3- and 5-year-survivals were 54% and 39%, compared with 23% and 0%, respectively, after R1/2-resection.
After a median follow-up of 25 months, tumors recurred in 63% patients after R0 resection.
In univariate analysis, Union Internationale Contre le Cancer stage was identified as important findings for recurrence and poor survival after R0 resection.
In addition, the team identified vascular invasion, and tumor grading as important findings for recurrence and poor survival after R0 resection.
For tumors without vascular invasion, the 3- and 5-year-survivals were 79% and 65%, respectively.
The team noted that this compared favorably with 21% and 7%, respectively, for tumors with vascular invasion.
The research team found that 3- and 5-year-survival rates were considerably better for G1 tumors.
The team noted that the corresponding 36% and 22% rates in G2, and 60% and 30% in G3 tumors, respectively.
Dr Lang's team concludes, "The 3- and 5-year survivals of 54% and 39%, respectively, after R0 resections suggest that surgery is an option in hepatocellular carcinoma arising in noncirrhotic livers."
"Longterm results, however, are hampered by high recurrence rates."
"Union Internationale Contre le Cancer stage, vascular invasion, and tumor grades are predictors of tumor recurrence and diminished survival, and may help to identify candidates for potential adjuvant therapies."