Journal Article

Characteristics and etiologies of hepatocellular carcinoma in patients without cirrhosis: When East meets West

Lin, Chih-Che, Yen, Yi-Hao, Wang, Jing-Houng, Cheng, Yu-Fan, Wang, Chih-Chi

2021

Overview

A recent study from the United States reported that nearly 12% of hepatocellular carcinomas (HCCs) occurred in patients without cirrhosis. Non-alcoholic fatty liver disease (NAFLD) was the most common liver disease in these patients. We aim to evaluate the characteristics, etiologies, and outcomes of cases of non-cirrhotic HCC in East Asia, where there is a higher prevalence of hepatitis B virus (HBV)-associated non-cirrhotic HCC. This retrospective study consecutively enrolled de novo HCC patients managed at our institution from 2011 to 2017. The presence of cirrhosis was assessed by histology; if histology was not available, it was assessed by image study. 2055 patients with HCC were enrolled in this study. Among them, 529 (25.7%) were non-cirrhotic. The non-cirrhotic patients were younger (60.9 vs. 62.5 years, p = 0.006), included a greater proportion of males (78.1% vs. 71.3%, p = 0.002), and had a lower body mass index (24.3 vs. 25.3 kg/m2, p<0.001) than the cirrhotic patients. Among the non-cirrhotic patients, HBV was the most common liver disease (49.0%). The patients with non-cirrhotic HCC had larger tumors (5.9 vs. 4.7 cm, p<0.001), underwent liver resection at a higher rate (66.0% vs. 17.4%, p<0.001), and had better overall survival than the cirrhotic HCC patients (median 5.67 vs. 2.83 years, p<0.001). Nearly 26% of the HCCs occurred in patients without cirrhosis. HBV was the most common liver disease in these patients, and the survival was better in the non-cirrhotic patients than the cirrhotic patients.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Ablation / Adult / Age / Alcohol / Biology and life sciences / Carcinoma, Hepatocellular - complications / Carcinoma, Hepatocellular - epidemiology / Carcinoma, Hepatocellular - etiology / Carcinoma, Hepatocellular - therapy / Causes of / Chemoembolization / Cirrhosis / Diagnosis / Diagnostic systems / Embolization / Enrollments / Etiology / Fatty liver / Female / Hepatitis B / Hepatocellular carcinoma / Hepatoma / Histology / Hospitals / Humans / Internal medicine / Liver / Liver cancer / Liver cirrhosis / Liver Cirrhosis - complications / Liver diseases / Liver Neoplasms - complications / Liver Neoplasms - epidemiology / Liver Neoplasms - etiology / Liver Neoplasms - therapy / Liver transplantation / Male / Medicine / Medicine and Health Sciences / Middle Aged / Mortality / Patient outcomes / Patients / Prevalence / Radio frequency / Radiology / Retrospective Studies / Surgery / Surveillance / Transplantation / Tumors