Prognostic factors after resection of hepatocellular carcinoma in the non-cirrhotic liver: Presentation of 51 cases

Abstract

BackgroundClinical presentation, treatment and prognosis of hepatocellular carcinoma depend on the presence or absence of cirrhosis. In the literature there are few reports of hepatocellular carcinoma in non-cirrhotic patients. ObjectiveTo describe a consecutive series of resected patients with hepatocellular carcinoma in non-cirrhotic liver and to identify prognostic factors of recurrence and survival. Material and methodsBetween 1990 and 2006, 51 patients were operated on. Data were collected retrospectively until 2001 and prospectively from then on. The results of surgery were assessed. Single and multivariate analyses were performed to identify factors associated with survival and disease-free survival. ResultsThirty-three patients were male, median age 49.8 years. A major hepatectomy was performed in 72%. Morbidity was 43% and mortality was 0%. One-, two- and three-year survival rates were 90%, 75%, and 67%, respectively. One-, two- and three-year disease-free survival rates were 65%, 41%, and 37%, respectively. Presence of vascular invasion and of positive nodes was statistically significant for survival in univariate analysis but had no statistical significance in multivariate analysis. ConclusionsMajor hepatic resection is a safe treatment for hepatocellular carcinoma in noncirrhotic patients. Both vascular invasion and presence of positive nodes were associated with poor survival. However, neither of them represented an independent variable.