Skip to main content
Top
Published in: BMC Gastroenterology 1/2023

Open Access 01-12-2023 | Hepatocellular Carcinoma | Research

Clinical characteristics, prognosis, and surgical outcomes of patients with non-HBV and non-HCV related hepatocellular carcinoma: three-decade observational study

Authors: Koya Yasukawa, Akira Shimizu, Koji Kubota, Tsuyoshi Notake, Kiyotaka Hosoda, Hikaru Hayashi, Yuji Soejima

Published in: BMC Gastroenterology | Issue 1/2023

Login to get access

Abstract

Background

The incidence of non-hepatitis B virus, non-hepatitis C virus hepatocellular carcinoma (non-B non-C-HCC) is increasing worldwide. We assessed the clinical characteristics and surgical outcomes of non-B non-C-HCC, versus hepatitis B (HBV-HCC) and hepatitis C (HCV-HCC).

Methods

Etiologies, fibrosis stages, and survival outcomes were analyzed of 789 consecutive patients who underwent surgery from 1990 to 2020 (HBV-HCC, n = 149; HCV-HCC, n = 424; non-B non-C-HCC, n = 216).

Results

The incidence of hypertension and diabetes mellitus was significantly higher in patients with NON-B NON-C-HCC than in those with HBV-HCC and HCV-HCC. Significantly more advanced tumor stages were observed in patients with non-B non-C-HCC; however, better liver function and lower fibrosis stages were observed. Patients with non-B non-C-HCC had significantly worse 5-year overall survival than patients with HBV-HCC; overall survival was comparable between patients with non-B non-C-HCC and HCV-HCC. Patients with HCV-HCC had significantly worse 5-year recurrence-free survival than patients with HBV-HCC and non-B non-C-HCC. In patients with non-B non-C-HCC, overall survival was comparable among three periods (1990–2000, 2001–2010, and 2011–2020) despite significant improvement in patients with HBV-HCC and HCV-HCC.

Conclusion

The prognosis of non-B non-C-HCC was similar to that of HBV-HCC and HCV-HCC regardless of tumor progression at surgery. Patients with hypertension, diabetes mellitus, and dyslipidemia require careful systematic follow-up and treatment.
Literature
1.
go back to reference Llovet JM, Kelley RK, Villanueva A, et al. Hepatocellular carcinoma. Nat Rev Dis Primers. 2021;7(1):6.CrossRefPubMed Llovet JM, Kelley RK, Villanueva A, et al. Hepatocellular carcinoma. Nat Rev Dis Primers. 2021;7(1):6.CrossRefPubMed
2.
go back to reference Omichi K, Shindoh J, Yamamoto S, et al. Postoperative outcomes for patients with non-B non-C hepatocellular carcinoma: a subgroup analysis of patients with a history of hepatitis B infection. Ann Surg Oncol. 2015;22(Suppl 3):S1034–40.CrossRefPubMed Omichi K, Shindoh J, Yamamoto S, et al. Postoperative outcomes for patients with non-B non-C hepatocellular carcinoma: a subgroup analysis of patients with a history of hepatitis B infection. Ann Surg Oncol. 2015;22(Suppl 3):S1034–40.CrossRefPubMed
3.
go back to reference Takeishi K, Maeda T, Shirabe K, et al. Clinicopathologic features and outcomes of non-B, non-C hepatocellular carcinoma after hepatectomy. Ann Surg Oncol. 2015;22(Suppl 3):S1116–24.CrossRefPubMed Takeishi K, Maeda T, Shirabe K, et al. Clinicopathologic features and outcomes of non-B, non-C hepatocellular carcinoma after hepatectomy. Ann Surg Oncol. 2015;22(Suppl 3):S1116–24.CrossRefPubMed
4.
go back to reference Nishikawa H, Osaki Y. Non-B, non-C hepatocellular carcinoma (Review). Int J Oncol. 2013;43(5):1333–42.CrossRefPubMed Nishikawa H, Osaki Y. Non-B, non-C hepatocellular carcinoma (Review). Int J Oncol. 2013;43(5):1333–42.CrossRefPubMed
5.
go back to reference Hashimoto M, Tashiro H, Kobayashi T, et al. Clinical characteristics and prognosis of non-B, non-C hepatocellular carcinoma: the impact of patient sex on disease-free survival - a retrospective cohort study. Int J Surg. 2017;39:206–13.CrossRefPubMed Hashimoto M, Tashiro H, Kobayashi T, et al. Clinical characteristics and prognosis of non-B, non-C hepatocellular carcinoma: the impact of patient sex on disease-free survival - a retrospective cohort study. Int J Surg. 2017;39:206–13.CrossRefPubMed
6.
go back to reference Ochiai T, Ogino S, Ishimoto T, et al. Prognostic impact of hepatectomy for patients with non-hepatitis B, non-hepatitis C hepatocellular carcinoma. Anticancer Res. 2014;34(8):4399–410.PubMed Ochiai T, Ogino S, Ishimoto T, et al. Prognostic impact of hepatectomy for patients with non-hepatitis B, non-hepatitis C hepatocellular carcinoma. Anticancer Res. 2014;34(8):4399–410.PubMed
7.
go back to reference Okamura Y, Ashida R, Yamamoto Y, et al. The FIB-4 index is a significant prognostic factor in patients with non-B non-C hepatocellular carcinoma after curative surgery. Langenbecks Arch Surg. 2016;401(2):195–203.CrossRefPubMed Okamura Y, Ashida R, Yamamoto Y, et al. The FIB-4 index is a significant prognostic factor in patients with non-B non-C hepatocellular carcinoma after curative surgery. Langenbecks Arch Surg. 2016;401(2):195–203.CrossRefPubMed
8.
go back to reference Zhang W, Tan Y, Jiang L, et al. Prognostic nomogram for patients with non-B non-C hepatocellular carcinoma after curative liver resection. Int J Surg. 2017;44:160–5.CrossRefPubMed Zhang W, Tan Y, Jiang L, et al. Prognostic nomogram for patients with non-B non-C hepatocellular carcinoma after curative liver resection. Int J Surg. 2017;44:160–5.CrossRefPubMed
9.
go back to reference Hsu PY, Hsu CT, Yeh ML, et al. Early fibrosis but late tumor stage and worse outcomes in hepatocellular carcinoma patients without hepatitis B or hepatitis C. Dig Dis Sci. 2020;65(7):2120–9.CrossRefPubMed Hsu PY, Hsu CT, Yeh ML, et al. Early fibrosis but late tumor stage and worse outcomes in hepatocellular carcinoma patients without hepatitis B or hepatitis C. Dig Dis Sci. 2020;65(7):2120–9.CrossRefPubMed
10.
go back to reference Kokudo N, Takemura N, Kanto T, et al. Hepatocellular carcinoma with non-B and non-C hepatitis origin: epidemiology in Japan and surgical outcome. Glob Health Med. 2019;1(1):23–9.CrossRefPubMedPubMedCentral Kokudo N, Takemura N, Kanto T, et al. Hepatocellular carcinoma with non-B and non-C hepatitis origin: epidemiology in Japan and surgical outcome. Glob Health Med. 2019;1(1):23–9.CrossRefPubMedPubMedCentral
11.
go back to reference Edge SB, Compton CC. The American joint committee on cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol. 2010;17(6):1471–4.CrossRefPubMed Edge SB, Compton CC. The American joint committee on cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol. 2010;17(6):1471–4.CrossRefPubMed
12.
go back to reference Makuuchi M, Kosuge T, Takayama T, et al. Surgery for small liver cancers. Semin Surg Oncol. 1993;9(4):298–304.CrossRefPubMed Makuuchi M, Kosuge T, Takayama T, et al. Surgery for small liver cancers. Semin Surg Oncol. 1993;9(4):298–304.CrossRefPubMed
13.
go back to reference Shimizu A, Kobayashi A, Yokoyama T, et al. Correlation between the serum levels of type IV collagen 7s domain and the risk of intractable ascites following liver resection for hepatocellular carcinoma: a propensity score-matched analysis. Surgery. 2016;160(5):1244–55.CrossRefPubMed Shimizu A, Kobayashi A, Yokoyama T, et al. Correlation between the serum levels of type IV collagen 7s domain and the risk of intractable ascites following liver resection for hepatocellular carcinoma: a propensity score-matched analysis. Surgery. 2016;160(5):1244–55.CrossRefPubMed
14.
go back to reference Imamura H, Seyama Y, Kokudo N, et al. One thousand fifty-six hepatectomies without mortality in 8 years. Arch Surg. 2003;138(11):1198–206 (discussion 206).CrossRefPubMed Imamura H, Seyama Y, Kokudo N, et al. One thousand fifty-six hepatectomies without mortality in 8 years. Arch Surg. 2003;138(11):1198–206 (discussion 206).CrossRefPubMed
15.
go back to reference Miyagawa S, Makuuchi M, Kawasaki S, Kakazu T. Criteria for safe hepatic resection. Am J Surg. 1995;169(6):589–94.CrossRefPubMed Miyagawa S, Makuuchi M, Kawasaki S, Kakazu T. Criteria for safe hepatic resection. Am J Surg. 1995;169(6):589–94.CrossRefPubMed
16.
go back to reference Hassan MM, Hwang LY, Hatten CJ, et al. Risk factors for hepatocellular carcinoma: synergism of alcohol with viral hepatitis and diabetes mellitus. Hepatology. 2002;36(5):1206–13.CrossRefPubMed Hassan MM, Hwang LY, Hatten CJ, et al. Risk factors for hepatocellular carcinoma: synergism of alcohol with viral hepatitis and diabetes mellitus. Hepatology. 2002;36(5):1206–13.CrossRefPubMed
17.
go back to reference Rahbari NN, Garden OJ, Padbury R, et al. Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery. 2011;149(5):713–24.CrossRefPubMed Rahbari NN, Garden OJ, Padbury R, et al. Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery. 2011;149(5):713–24.CrossRefPubMed
18.
go back to reference Koch M, Garden OJ, Padbury R, et al. Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the International study group of liver surgery. Surgery. 2011;149(5):680–8.CrossRefPubMed Koch M, Garden OJ, Padbury R, et al. Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the International study group of liver surgery. Surgery. 2011;149(5):680–8.CrossRefPubMed
19.
go back to reference Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.CrossRefPubMedPubMedCentral Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.CrossRefPubMedPubMedCentral
20.
go back to reference Imamura H, Matsuyama Y, Miyagawa Y, et al. Prognostic significance of anatomical resection and des-gamma-carboxy prothrombin in patients with hepatocellular carcinoma. Br J Surg. 1999;86(8):1032–8.CrossRefPubMed Imamura H, Matsuyama Y, Miyagawa Y, et al. Prognostic significance of anatomical resection and des-gamma-carboxy prothrombin in patients with hepatocellular carcinoma. Br J Surg. 1999;86(8):1032–8.CrossRefPubMed
21.
go back to reference Lin K, Huang Q, Huo Y, et al. Development and validation of a prognostic nomogram to predict the long-time prognosis in non-B non-C hepatocellular carcinoma. Cancer Manag Res. 2020;12:7771–81.CrossRefPubMedPubMedCentral Lin K, Huang Q, Huo Y, et al. Development and validation of a prognostic nomogram to predict the long-time prognosis in non-B non-C hepatocellular carcinoma. Cancer Manag Res. 2020;12:7771–81.CrossRefPubMedPubMedCentral
22.
go back to reference Li Y, Chen Y, Chen J. Diagnostic value of serum biomarkers for patients undergoing curative resection with non-B, non-C hepatocellular carcinoma. J Coll Phys Surg Pak. 2020;30(2):134–8. Li Y, Chen Y, Chen J. Diagnostic value of serum biomarkers for patients undergoing curative resection with non-B, non-C hepatocellular carcinoma. J Coll Phys Surg Pak. 2020;30(2):134–8.
23.
go back to reference Wu SS, Shan QY, Xie WX, et al. Outcomes after hepatectomy of patients with positive HBcAb non-B non-C hepatocellular carcinoma compared to overt hepatitis B virus hepatocellular carcinoma. Clin Transl Oncol. 2020;22(3):401–10.CrossRefPubMed Wu SS, Shan QY, Xie WX, et al. Outcomes after hepatectomy of patients with positive HBcAb non-B non-C hepatocellular carcinoma compared to overt hepatitis B virus hepatocellular carcinoma. Clin Transl Oncol. 2020;22(3):401–10.CrossRefPubMed
24.
go back to reference Okamura Y, Sugiura T, Ito T, et al. The impact of the hepatitis B core antibody status on recurrence in patients with non-B non-C hepatocellular carcinoma after curative surgery. Dig Surg. 2018;35(3):243–51.CrossRefPubMed Okamura Y, Sugiura T, Ito T, et al. The impact of the hepatitis B core antibody status on recurrence in patients with non-B non-C hepatocellular carcinoma after curative surgery. Dig Surg. 2018;35(3):243–51.CrossRefPubMed
25.
go back to reference Kim SK, Marusawa H, Eso Y, et al. Clinical characteristics of non-B non-C hepatocellular carcinoma: a single-center retrospective study. Digestion. 2011;84(Suppl 1):43–9.CrossRefPubMed Kim SK, Marusawa H, Eso Y, et al. Clinical characteristics of non-B non-C hepatocellular carcinoma: a single-center retrospective study. Digestion. 2011;84(Suppl 1):43–9.CrossRefPubMed
26.
go back to reference Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73–84.CrossRefPubMed Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73–84.CrossRefPubMed
27.
go back to reference Dudek M, Pfister D, Donakonda S, et al. Auto-aggressive CXCR6(+) CD8 T cells cause liver immune pathology in NASH. Nature. 2021;592(7854):444–9.CrossRefPubMed Dudek M, Pfister D, Donakonda S, et al. Auto-aggressive CXCR6(+) CD8 T cells cause liver immune pathology in NASH. Nature. 2021;592(7854):444–9.CrossRefPubMed
Metadata
Title
Clinical characteristics, prognosis, and surgical outcomes of patients with non-HBV and non-HCV related hepatocellular carcinoma: three-decade observational study
Authors
Koya Yasukawa
Akira Shimizu
Koji Kubota
Tsuyoshi Notake
Kiyotaka Hosoda
Hikaru Hayashi
Yuji Soejima
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2023
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-023-02833-0

Other articles of this Issue 1/2023

BMC Gastroenterology 1/2023 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.