Prognosis After Resection of Hepatitis B Virus-Related Hepatocellular Carcinoma Originating from Non-cirrhotic Liver

• Published in: Annals of surgical oncology Vol. 21; no. 7; pp. 2406 - 2412
• Main Authors: Zhou, Yan-Ming, Zhang, Xiao-Feng, Li, Bin, Sui, Cheng-Jun, Yang, Jia-Mei
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.07.2014; Springer Nature B.V
• Subjects: Carcinoma, Hepatocellular - etiology; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - surgery; Female; Follow-Up Studies; Hepatectomy; Hepatitis B - complications; Hepatitis B - mortality; Hepatitis B - surgery; Hepatitis B - virology; Hepatitis B virus; Hepatitis B virus - pathogenicity; Hepatobiliary Tumors; Humans; Liver - pathology; Liver - virology; Liver Cirrhosis - complications; Liver Cirrhosis - pathology; Liver Cirrhosis - virology; Liver Neoplasms - etiology; Liver Neoplasms - mortality; Liver Neoplasms - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Staging; Oncology; Prognosis; Retrospective Studies; Surgery; Surgical Oncology; Survival Rate; Hybrid Capture Assay; Carcinogenetic Potential; Infection Group; Overall Survival
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/s10434-014-3505-0

Background Long-term prognosis after resection of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) originating from non-cirrhotic liver is not fully clarified. Methods A total of 183 patients who underwent curative hepatectomy for HCC without cirrhosis were classified into two groups: HBV infection group ( n  = 124) and non-HBV infection group ( n  = 59). Long-term postoperative outcomes were compared between the two groups. Results The 5-year postoperative overall survival (OS) and disease-free survival (DFS) were 42.6 and 39.0 %, respectively, in the HBV infection group versus 52.3 and 46.5 % in the non-HBV infection group (both p  > 0.05). When patients were subdivided according to TNM stages, OS in stages II or III HCC patients was similar between the two groups. In contrast, OS and DFS were significantly worse in stage I patients with HBV infection than those in stage I patients without HBV infection ( p  = 0.041 and 0.038, respectively). Preoperative serum HBV DNA >4 log 10 copies/mL and vascular invasion were independent factors associated with poor prognosis ( p  = 0.034 and 0.017, respectively) for patients with HBV infection. Conclusions After hepatic resection for HCC in non-cirrhotic liver, patients with HBV infection with early-stage tumors had worse prognosis than patients without HBV infection, possibly due to the carcinogenetic potential of viral hepatitis in the remnant liver. Antiviral therapy should be considered after hepatectomy in patients with high HBV DNA levels.