Different intrahepatic recurrence rate after resection of hepatocellular carcinoma associated with chronic hepatitis B and C

Abstract

Hepatocellular carcinoma (HCC) occurs more prevalently in livers, not only with cirrhosis but chronic hepatitis due to hepatitis C virus (HCV), than in hepatitis B virus (HBV) related counterparts. This study aimed to investigate intrahepatic recurrence (IHR) and underlying mechanisms after resection of HCC associated with chronic hepatitis B and C from the viewpoint of hepatocarcinogenesis. A total of 44 patients with HCC and chronic hepatitis due to HBV in 15 patients and HCV in 29 patients were carefully followed up after curative hepatic resection. Clinical backgrounds, preoperative laboratory data, histopathologies of HCC and liver were compared between the two groups. Prognostic factors were analyzed by univariate and multivariate analyses. There were no differences in clinical backgrounds except for higher age in C hepatitis ( P=0.0048). Preoperative laboratory data were better in B hepatitis; AST ( P=0.0021, t-test), ALT ( P=0.0039), albumin ( P=0.0230), ICG test ( P=0.0043), platelet count ( P=0.0080), and plasma fibrinogen ( P=0.0224). No significant differences were found in tumor size or stage and other tumoral factors. Although the extent of hepatic fibrosis was similar, necroinflammatory activity was higher in C hepatitis ( P=0.0081). IHR rate was higher in C (65.5%) than in B hepatitis ( P=0.0145), but there was no difference in the recurrence pattern and time. The 5-year disease-free survival rate was 10.9% in C versus 84.6% in B hepatitis ( P=0.0018, log-rank test; P=0.0068, Wilcoxon test). Multivariate analysis revealed that the type of hepatitis virus and tumor size were independent factors for IHR. IHR occurs more frequently in chronic hepatitis C. Higher age and higher hepatitis activity may partly be responsible for this but further studies are necessary to elucidate the differences in carcinogenic potential and mechanism between chronic hepatitis B and C.