科研之友
微信
新浪微博
Facebook
分享链接
摘要
Background. Although cirrhosis is common among Western hepatocellular carcinoina (HCC) patients, a substantial proportion are not cirrhotic. Studies examining surgical outcomes in noncirrhotic patients primarily evaluate-Asian populations and liver resections. We describe cirrhotic and noncirrhotic HCC patients undergoing resection and transplantation. at a Western institution. Methods. We retrospectively reviewed 188 HCC patients treated surgically from 2000 to 2011 at a single Western institution. The primary endpoint was recurrence. Secondary endpoints included time to recurrence and overall survival. Results. We evaluated 138 cirrhotic and 50 noncirrhotic patients with a. median follow-up of 33.8 months. Noncirrhotics mostly underwent liver resection (90%), whereas cirrhotics primarily underwent transplantation (67%). Hepatitis B was the most common underlying liver disease for noncirrhotics (64%), whereas hepatitis C (55%) and alcohol abuse (32%) predominated among cirrhotics. Pathologic evaluation demonstrated tumors in noncirrhotics that were fewer in number, larger, less differentiated, and more likely to have vascular invasion. Recurrence was more common for noncirrhotics (36 vs 18%; P = .008) and more common after resection compared with transplantation. Overall median survival was 46.9 months for both groups. After resection; noncirrhotics had longer survival times than did cirrhotics (41.6 vs 32.9 months; P = .04). Vascular invasion was an independent predictor for recurrence; tumor size was a predictor of mortality. Conclusion. Noncirrhotics in our Western cohort had higher risk pathologic features, more frequently underwent resection, and suffered more recurrences than did cirrhotics. Overall survival was similar for both groups. Prospective studies of noncirrhotic HCC patients in Asia and Western countries may inform surveillance and treatment.
- 出版日期2013-9
