Skip to main content
Top
Published in: World Journal of Surgery 4/2011

01-04-2011

A Comparison of Prognosis between Patients with Hepatitis B and C Virus-related Hepatocellular Carcinoma Undergoing Resection Surgery

Authors: Wei-Yu Kao, Chien-Wei Su, Gar-Yang Chau, Wing-Yiu Lui, Chew-Wun Wu, Jaw-Ching Wu

Published in: World Journal of Surgery | Issue 4/2011

Login to get access

Abstract

Background

The impact of viral factors on the prognosis of hepatocellular carcinoma (HCC) remains controversial because of heterogeneous populations included in previous reports. This study aims to compare clinicopathologic features and prognoses between patients with hepatitis B- and hepatitis C-related HCC who underwent resection surgery.

Methods

We enrolled 609 patients with positive serum hepatitis B virus (HBV) surface antigen (HBsAg) and negative serum antibody against hepatitis C virus (anti-HCV) as the B-HCC group and 206 patients with negative serum HBsAg and positive anti-HCV as the C-HCC group. The overall survival rates and cumulative recurrence rates were compared between these two groups.

Results

B-HCC patients were significantly younger, predominantly male, had better liver functional reserve, but more advanced tumor stage than C-HCC patients. After a median follow-up period of 40.6 months, 427 patients had died. Furthermore, 501 patients had tumor recurrence after surgery. The postoperative overall survival rates (p = 0.640) and recurrence rates (p = 0.387) of the two groups were comparable. However, the overall survival rate was higher in the B-HCC group than in the C-HCC group in the cases of transplantable HCC (p = 0.021) and Barcelona-Clinic Liver Cancer stage A HCC (p = 0.040).

Conclusions

Viral etiologies were not apparent in determining outcomes of HCC patients who underwent resection due to heterogeneous studied populations. In early-stage HCC, B-HCC patients had better outcomes than C-HCC patients did because of better liver reserve and less hepatic inflammation.
Literature
1.
go back to reference Llovet JM, Bruix J (2008) Novel advancements in the management of hepatocellular carcinoma in 2008. J Hepatol 48(Suppl 1):S20–S37PubMedCrossRef Llovet JM, Bruix J (2008) Novel advancements in the management of hepatocellular carcinoma in 2008. J Hepatol 48(Suppl 1):S20–S37PubMedCrossRef
2.
go back to reference Ferenci P, Fried M, Labrecque D et al (2010) Hepatocellular carcinoma (HCC): a global perspective. J Clin Gastroenterol 44:239–245PubMedCrossRef Ferenci P, Fried M, Labrecque D et al (2010) Hepatocellular carcinoma (HCC): a global perspective. J Clin Gastroenterol 44:239–245PubMedCrossRef
3.
go back to reference El-Serag HB, Marrero JA, Rudolph L et al (2008) Diagnosis and treatment of hepatocellular carcinoma. Gastroenterology 134:1752–1763PubMedCrossRef El-Serag HB, Marrero JA, Rudolph L et al (2008) Diagnosis and treatment of hepatocellular carcinoma. Gastroenterology 134:1752–1763PubMedCrossRef
4.
go back to reference Mazzaferro V, Romito R, Schiavo M et al (2006) Prevention of hepatocellular carcinoma recurrence with alpha-interferon after liver resection in HCV cirrhosis. Hepatology 44:1543–1554PubMedCrossRef Mazzaferro V, Romito R, Schiavo M et al (2006) Prevention of hepatocellular carcinoma recurrence with alpha-interferon after liver resection in HCV cirrhosis. Hepatology 44:1543–1554PubMedCrossRef
5.
go back to reference Wu JC, Huang YH, Chau GY et al (2009) Risk factors for early and late recurrence in hepatitis B-related hepatocellular carcinoma. J Hepatol 51:890–897PubMedCrossRef Wu JC, Huang YH, Chau GY et al (2009) Risk factors for early and late recurrence in hepatitis B-related hepatocellular carcinoma. J Hepatol 51:890–897PubMedCrossRef
6.
go back to reference Imamura H, Matsuyama Y, Tanaka E et al (2003) Risk factors contributing to early and date phase intrahepatic recurrence of hepatocellular carcinoma after hepatectomy. J Hepatol 38:200–207PubMedCrossRef Imamura H, Matsuyama Y, Tanaka E et al (2003) Risk factors contributing to early and date phase intrahepatic recurrence of hepatocellular carcinoma after hepatectomy. J Hepatol 38:200–207PubMedCrossRef
7.
go back to reference Schlaeger C, Longerich T, Schiller C et al (2008) Etiology-dependent molecular mechanisms in human hepatocarcinogenesis. Hepatology 47:511–520PubMedCrossRef Schlaeger C, Longerich T, Schiller C et al (2008) Etiology-dependent molecular mechanisms in human hepatocarcinogenesis. Hepatology 47:511–520PubMedCrossRef
8.
go back to reference Tan A, Yeh SH, Liu CJ et al (2008) Viral hepatocarcinogenesis: from infection to cancer. Liver Int 28:175–188PubMedCrossRef Tan A, Yeh SH, Liu CJ et al (2008) Viral hepatocarcinogenesis: from infection to cancer. Liver Int 28:175–188PubMedCrossRef
9.
go back to reference Bartosch B, Thimme R, Blum HE et al (2009) Hepatitis C virus-induced hepatocarcinogenesis. J Hepatol 51:810–820PubMedCrossRef Bartosch B, Thimme R, Blum HE et al (2009) Hepatitis C virus-induced hepatocarcinogenesis. J Hepatol 51:810–820PubMedCrossRef
10.
go back to reference Huo TI, Huang YH, Hsia CY et al (2009) Characteristics and outcome of patients with dual hepatitis B and C-associated hepatocellular carcinoma: are they different from patients with single virus infection? Liver Int 29:767–773PubMedCrossRef Huo TI, Huang YH, Hsia CY et al (2009) Characteristics and outcome of patients with dual hepatitis B and C-associated hepatocellular carcinoma: are they different from patients with single virus infection? Liver Int 29:767–773PubMedCrossRef
11.
go back to reference Cescon M, Cucchetti A, Grazi GL et al (2009) Role of hepatitis B virus infection in the prognosis after hepatectomy for hepatocellular carcinoma in patients with cirrhosis: a Western dual-center experience. Arch Surg 144:906–913PubMedCrossRef Cescon M, Cucchetti A, Grazi GL et al (2009) Role of hepatitis B virus infection in the prognosis after hepatectomy for hepatocellular carcinoma in patients with cirrhosis: a Western dual-center experience. Arch Surg 144:906–913PubMedCrossRef
12.
go back to reference Kondo K, Chijiiwa K, Funagayama M et al (2008) Differences in long-term outcome and prognostic factors according to viral status in patients with hepatocellular carcinoma treated by surgery. J Gastrointest Surg 12:468–476PubMedCrossRef Kondo K, Chijiiwa K, Funagayama M et al (2008) Differences in long-term outcome and prognostic factors according to viral status in patients with hepatocellular carcinoma treated by surgery. J Gastrointest Surg 12:468–476PubMedCrossRef
13.
go back to reference Li Q, Li H, Qin Y et al (2007) Comparison of surgical outcomes for small hepatocellular carcinoma in patients with hepatitis B versus hepatitis C: a Chinese experience. J Gastroenterol Hepatol 22:1936–1941PubMedCrossRef Li Q, Li H, Qin Y et al (2007) Comparison of surgical outcomes for small hepatocellular carcinoma in patients with hepatitis B versus hepatitis C: a Chinese experience. J Gastroenterol Hepatol 22:1936–1941PubMedCrossRef
14.
go back to reference Chen CH, Huang GT, Yang PM et al (2006) Hepatitis B- and C-related hepatocellular carcinomas yield different clinical features and prognosis. Eur J Cancer 42:2524–2529PubMedCrossRef Chen CH, Huang GT, Yang PM et al (2006) Hepatitis B- and C-related hepatocellular carcinomas yield different clinical features and prognosis. Eur J Cancer 42:2524–2529PubMedCrossRef
15.
go back to reference Huang YH, Wu JC, Chen CH et al (2005) Comparison of recurrence after hepatic resection in patients with hepatitis B vs. hepatitis C-related small hepatocellular carcinoma in hepatitis B virus endemic area. Liver Int 25:236–241PubMedCrossRef Huang YH, Wu JC, Chen CH et al (2005) Comparison of recurrence after hepatic resection in patients with hepatitis B vs. hepatitis C-related small hepatocellular carcinoma in hepatitis B virus endemic area. Liver Int 25:236–241PubMedCrossRef
16.
go back to reference Cantarini MC, Trevisani F, Morselli-Labate AM et al (2006) Effect of the etiology of viral cirrhosis on the survival of patients with hepatocellular carcinoma. Am J Gastroenterol 101:91–98PubMedCrossRef Cantarini MC, Trevisani F, Morselli-Labate AM et al (2006) Effect of the etiology of viral cirrhosis on the survival of patients with hepatocellular carcinoma. Am J Gastroenterol 101:91–98PubMedCrossRef
17.
go back to reference Roayaie S, Haim MB, Emre S et al (2000) Comparison of surgical outcomes for hepatocellular carcinoma in patients with hepatitis B versus hepatitis C: a Western experience. Ann Surg Oncol 7:764–770PubMedCrossRef Roayaie S, Haim MB, Emre S et al (2000) Comparison of surgical outcomes for hepatocellular carcinoma in patients with hepatitis B versus hepatitis C: a Western experience. Ann Surg Oncol 7:764–770PubMedCrossRef
18.
go back to reference Miyagawa S, Kawasaki S, Makuuchi M (1996) Comparison of the characteristics of hepatocellular carcinoma between hepatitis B and C viral infection: tumor multicentricity in cirrhotic liver with hepatitis C. Hepatology 24:307–310PubMedCrossRef Miyagawa S, Kawasaki S, Makuuchi M (1996) Comparison of the characteristics of hepatocellular carcinoma between hepatitis B and C viral infection: tumor multicentricity in cirrhotic liver with hepatitis C. Hepatology 24:307–310PubMedCrossRef
19.
go back to reference Hung HH, Chiou YY, Hsia CY et al (2011) Survival rates are comparable following radiofrequency ablation or surgery in patients with small hepatocellular carcinomas. Clin Gastroenterol Hepatol 9:79–86 PubMedCrossRef Hung HH, Chiou YY, Hsia CY et al (2011) Survival rates are comparable following radiofrequency ablation or surgery in patients with small hepatocellular carcinomas. Clin Gastroenterol Hepatol 9:79–86 PubMedCrossRef
20.
go back to reference Lei HJ, Chau GY, Lui WY et al (2006) Prognostic value and clinical relevance of the 6th edition 2002 American Joint Committee on Cancer staging system in patients with resectable hepatocellular carcinoma. J Am Coll Surg 203:426–435PubMedCrossRef Lei HJ, Chau GY, Lui WY et al (2006) Prognostic value and clinical relevance of the 6th edition 2002 American Joint Committee on Cancer staging system in patients with resectable hepatocellular carcinoma. J Am Coll Surg 203:426–435PubMedCrossRef
21.
go back to reference Hsu KY, Chau GY, Lui WY et al (2009) Predicting morbidity and mortality after hepatic resection in patients with hepatocellular carcinoma: the role of model for end-stage liver disease score. World J Surg 33:2412–2419PubMedCrossRef Hsu KY, Chau GY, Lui WY et al (2009) Predicting morbidity and mortality after hepatic resection in patients with hepatocellular carcinoma: the role of model for end-stage liver disease score. World J Surg 33:2412–2419PubMedCrossRef
22.
go back to reference Hung HH, Su CW, Lai CR et al (2010) Fibrosis and AST to platelet ratio index predict post-operative prognosis for solitary small hepatitis-B related hepatocellular carcinoma. Hepatol Int 4:691–699PubMedCrossRef Hung HH, Su CW, Lai CR et al (2010) Fibrosis and AST to platelet ratio index predict post-operative prognosis for solitary small hepatitis-B related hepatocellular carcinoma. Hepatol Int 4:691–699PubMedCrossRef
23.
go back to reference Edmondson HA, Steiner PE (1954) Primary carcinoma of the liver: a study of 100 cases among 48,900 necropsies. Cancer 7:462–503PubMedCrossRef Edmondson HA, Steiner PE (1954) Primary carcinoma of the liver: a study of 100 cases among 48,900 necropsies. Cancer 7:462–503PubMedCrossRef
24.
go back to reference Bruix J, Sherman M, Llovet JM et al (2001) Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol 35:421–430PubMedCrossRef Bruix J, Sherman M, Llovet JM et al (2001) Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol 35:421–430PubMedCrossRef
25.
go back to reference Mazzaferro V, Regalia E, Doci R et al (1996) Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 334:693–699PubMedCrossRef Mazzaferro V, Regalia E, Doci R et al (1996) Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 334:693–699PubMedCrossRef
26.
go back to reference Chen CH, Chang TT, Cheng KS et al (2006) Do young hepatocellular carcinoma patients have worse prognosis? The paradox of age as a prognostic factor in the survival of hepatocellular carcinoma patients. Liver Int 26:766–773PubMedCrossRef Chen CH, Chang TT, Cheng KS et al (2006) Do young hepatocellular carcinoma patients have worse prognosis? The paradox of age as a prognostic factor in the survival of hepatocellular carcinoma patients. Liver Int 26:766–773PubMedCrossRef
27.
go back to reference Wang SH, Yeh SH, Lin WH et al (2009) Identification of androgen response elements in the enhancer I of hepatitis B virus: a mechanism for sex disparity in chronic hepatitis B. Hepatology 50:1392–1402PubMedCrossRef Wang SH, Yeh SH, Lin WH et al (2009) Identification of androgen response elements in the enhancer I of hepatitis B virus: a mechanism for sex disparity in chronic hepatitis B. Hepatology 50:1392–1402PubMedCrossRef
28.
go back to reference Chiu CM, Yeh SH, Chen PJ et al (2007) Hepatitis B virus X protein enhances androgen receptor-responsive gene expression depending on androgen level. Proc Natl Acad Sci USA 104:2571–2578PubMedCrossRef Chiu CM, Yeh SH, Chen PJ et al (2007) Hepatitis B virus X protein enhances androgen receptor-responsive gene expression depending on androgen level. Proc Natl Acad Sci USA 104:2571–2578PubMedCrossRef
29.
go back to reference Yang MH, Chen CL, Chau GY et al (2009) Comprehensive analysis of the independent effect of twist and snail in promoting metastasis of hepatocellular carcinoma. Hepatology 50:1464–1474PubMedCrossRef Yang MH, Chen CL, Chau GY et al (2009) Comprehensive analysis of the independent effect of twist and snail in promoting metastasis of hepatocellular carcinoma. Hepatology 50:1464–1474PubMedCrossRef
30.
go back to reference Shimada K, Sano T, Sakamoto Y et al (2005) A long-term follow-up and management study of hepatocellular carcinoma patients surviving for 10 years or longer after curative hepatectomy. Cancer 104:1939–1947PubMedCrossRef Shimada K, Sano T, Sakamoto Y et al (2005) A long-term follow-up and management study of hepatocellular carcinoma patients surviving for 10 years or longer after curative hepatectomy. Cancer 104:1939–1947PubMedCrossRef
31.
go back to reference Fukuda S, Itamoto T, Amano H et al (2007) Clinicopathologic features of hepatocellular carcinoma patients with compensated cirrhosis surviving more than 10 years after curative hepatectomy. World J Surg 31:345–352PubMedCrossRef Fukuda S, Itamoto T, Amano H et al (2007) Clinicopathologic features of hepatocellular carcinoma patients with compensated cirrhosis surviving more than 10 years after curative hepatectomy. World J Surg 31:345–352PubMedCrossRef
Metadata
Title
A Comparison of Prognosis between Patients with Hepatitis B and C Virus-related Hepatocellular Carcinoma Undergoing Resection Surgery
Authors
Wei-Yu Kao
Chien-Wei Su
Gar-Yang Chau
Wing-Yiu Lui
Chew-Wun Wu
Jaw-Ching Wu
Publication date
01-04-2011
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 4/2011
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-010-0928-z

Other articles of this Issue 4/2011

World Journal of Surgery 4/2011 Go to the issue