Abstract
BackgroundHCC predominantly develops in the condition of chronic inflammation that has led to liver cirrhosis. A small proportion of patients with HCC is diagnosed in the non-cirrhotic liver (NCL). Data on patients with HCC in NCL in advanced stages are scarce.MethodsA retrospective analysis was performed comparing 93 patients with HCC in NCL to 571 patients with HCC in liver cirrhosis (LC) with respect to clinical and demographic characteristics. Also factors influencing survival in patients with HCC in NCL were analyzed.ResultsPatients with HCC in NCL were diagnosed at older age and in more advanced tumor stages than patients with LC. More than 25% of patients with HCC in NCL presented with extrahepatic metastases. Only a minority of patients with HCC in NCL lacked any sign of hepatic damage. Risk factors for LC and risk factors for NAFLD are present in the majority of patients with HCC in NCL. The BCLC classification corresponded with the survival of patients with HCC in NCL although the therapeutic options differ from those for patients with liver cirrhosis.ConclusionsIt will be one of the major challenges in the future to awake awareness of carrying a risk of hepatic malignancies in patients with chronic liver diseases apart from liver cirrhosis, especially in NAFLD. Surveillance programs need to be implemented if these are cost-effective.
Highlights
hepatocellular carcinoma (HCC) predominantly develops in the condition of chronic inflammation that has led to liver cirrhosis
Patients with liver cirrhosis (LC) and HCC were diagnosed at a median age of 66 years while patients with HCC in non-cirrhotic liver (NCL) were diagnosed at a statistically significant older age (median age 69 years, p = 0.004) (Figure 1)
Of 571 patients with HCC in LC, 103 were female, resulting in a male to female ratio of 4.5:1 while the proportion of female patients was larger in patients with HCC in NCL with a male to female ratio of 2.7:1 (p = 0.045)
Summary
HCC predominantly develops in the condition of chronic inflammation that has led to liver cirrhosis. A small proportion of patients with HCC is diagnosed in the non-cirrhotic liver (NCL). Data on patients with HCC in NCL in advanced stages are scarce. HCC develops predominantly in the condition of chronic inflammation evolving into liver cirrhosis (LC) [2]. The proportion of patients with HCC diagnosed in a non-cirrhotic liver (NCL) varies throughout different geographic regions of the world ranging from 7% to 54% and depends strongly on the leading risk factor for hepatocarcinogenesis [4].
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