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:

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.

• Authors: Kiyohiko Omichi, Junichi Shindoh, Satoshi Yamamoto, Yutaka Matsuyama, Nobuhisa Akamatsu, Junichi Arita, Junichi Kaneko, Yoshihiro Sakamoto, Kiyoshi Hasegawa, Norihiro Kokudo
• Journal: Annals of surgical oncology (Ann Surg Oncol) Vol. 22 Suppl 3 Pg. S1034-40 (Dec 2015) ISSN: 1534-4681 [Electronic] United States
• PMID: 26350363 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Biomarkers
• Hepatitis B Surface Antigens

Topics

• Adult
• Aged
• Aged, 80 and over
• Biomarkers (analysis)
• Carcinoma, Hepatocellular (mortality, pathology, surgery, virology)
• Female
• Follow-Up Studies
• Hepatitis B (mortality, pathology, surgery, virology)
• Hepatitis B Surface Antigens (metabolism)
• Hepatitis B virus (isolation & purification)
• Humans
• Liver Neoplasms (mortality, pathology, surgery, virology)
• Male
• Middle Aged
• Neoplasm Staging
• Postoperative Complications
• Prognosis
• Retrospective Studies
• Survival Rate
• Young Adult