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01-12-2015 | Hepatobiliary Tumors

Postoperative Outcomes for Patients with Non-B Non-C Hepatocellular Carcinoma: A Subgroup Analysis of Patients with a History of Hepatitis B Infection

Authors: Kiyohiko Omichi, MD, PhD, Junichi Shindoh, MD, PhD, Satoshi Yamamoto, MD, PhD, Yutaka Matsuyama, PhD, Nobuhisa Akamatsu, MD, PhD, Junichi Arita, MD, PhD, Junichi Kaneko, MD, PhD, Yoshihiro Sakamoto, MD, PhD, Kiyoshi Hasegawa, MD, PhD, Norihiro Kokudo, MD, PhD

Published in: Annals of Surgical Oncology | Special Issue 3/2015

Abstract

Background

Hepatocellular carcinoma (HCC) not associated with active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, termed non-B non-C HCC (nBnC-HCC), is reportedly correlated with better survival outcomes than HBV- or HCV-related HCC. However, the nBnC-HCC population includes patients with a history of HBV infection possessing anti-hepatitis B core antibodies (HBcAb), and the oncologic significance of this finding remains unclear.

Methods

A retrospective review of the data for 562 patients who underwent curative resection for primary HCC was performed. The clinical outcomes were compared among the following four groups: HBV group (HBsAg-positive), HCV group (HCVAb-positive), HBcAb-positive nBnC-HCC group, and pure nBnC-HCC group (negative for these viral markers).

Results

The HBcAb-positive nBnC-HCC group showed better overall survival (OS) and recurrence-free survival (RFS) rates than the HBV, HCV, and pure nBnC-HCC groups (5-year OS 89.4 vs 68.4, 62.0, and 66.2 %; P = 0.003; 5-year RFS 53.8 vs 31.4, 28.1, and 33.6 %; P = 0.01). A multivariate analysis confirmed that a history of HBV is associated with a lower risk of OS (hazard ratio [HR] 0.23; 95 % confidence interval [CI] 0.09–0.56; P = 0.001) and RFS (HR 0.45; 95 % CI 0.27–0.73; P = 0.001). The HBcAb-positive nBnC-HCC group was associated with a higher incidence of well-differentiated HCC (33 vs 15 %; P = 0.03) and lower plasma des-gamma-carboxyprothrombin concentration (72 vs 357 mAu/mL; P = 0.047) than the pure nBnC group.

Conclusion

The subgroup of patients with a history of HBV infection may have better survival outcomes after resection of HCC than the HBV/HCV-related or pure nBnC-HCC patients.

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Title: Postoperative Outcomes for Patients with Non-B Non-C Hepatocellular Carcinoma: A Subgroup Analysis of Patients with a History of Hepatitis B Infection
Authors: Kiyohiko Omichi, MD, PhD
Junichi Shindoh, MD, PhD
Satoshi Yamamoto, MD, PhD
Yutaka Matsuyama, PhD
Nobuhisa Akamatsu, MD, PhD
Junichi Arita, MD, PhD
Junichi Kaneko, MD, PhD
Yoshihiro Sakamoto, MD, PhD
Kiyoshi Hasegawa, MD, PhD
Norihiro Kokudo, MD, PhD
Publication date: 01-12-2015
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue Special Issue 3/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-015-4845-0

At a glance: The STEP trials

Springer Medicine

Postoperative Outcomes for Patients with Non-B Non-C Hepatocellular Carcinoma: A Subgroup Analysis of Patients with a History of Hepatitis B Infection

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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