Erschienen in:
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
verfasst von:
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
Erschienen in:
Annals of Surgical Oncology
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Sonderheft 3/2015
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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.