Author information
1
Department of Surgery, Division of Surgical Oncology, University of Tennessee Health Science Center, 910 Madison Avenue, 3rd Floor, Memphis, TN, 38163, USA.
2
West Cancer Center, Memphis, TN, USA.
3
Memphis Pathology Group, 1211 Union Avenue, Suite 300, Memphis, TN, 38104, USA.
4
Transplant Center, Cleveland Clinic Florida-Weston, 2950 Cleveland Clinic Blvd., Weston, FL, 33331, USA.
5
Methodist University Transplant Institute, Sherard Wing, First Floor, 1265 Union Ave., Memphis, TN, 38104, USA.
6
Department of Surgery, Division of Surgical Oncology, University of Tennessee Health Science Center, 910 Madison Avenue, 3rd Floor, Memphis, TN, 38163, USA. pdickso1@uthsc.edu.
7
West Cancer Center, Memphis, TN, USA. pdickso1@uthsc.edu.
Abstract
BACKGROUND:
Hepatocellular carcinoma (HCC) occasionally occurs in non-cirrhotic patients; however, outcomes for these patients are not extensively documented.
METHODS:
We performed an institutional review of patients without cirrhosis who underwent resection for HCC. Clinical data were evaluated to identify factors impacting recurrence-free survival (RFS) and overall survival (OS).
RESULTS:
Forty-two patients underwent hepatectomy for HCC in the absence of cirrhosis over a 10-year period. Median follow-up was 22 months. For the entire cohort, 1-, 3-, and 5-year RFS was 62%, 42%, and 38% and 1-, 3-, and 5-year OS was 78%, 60%, and 49%, respectively. On univariate analysis, RFS was significantly worse for patients with a disrupted/absent tumor capsule (p = 0.027), vascular invasion (p = 0.030), elevated alkaline phosphatase (p = 0.004), and tumor size > 10 cm (p = 0.016). OS was significantly worse for patients with a disrupted/absent tumor capsule (p = 0.044), obesity (p = 0.036), and elevated alkaline phosphatase (p = 0.007) with a trend towards decreased OS for tumor size > 10 cm (p = 0.07).
CONCLUSIONS:
Patients undergoing resection for HCC in the absence of cirrhosis have fairly high recurrence and modest survival rates. Pre-operative alkaline phosphatase, tumor size, tumor encapsulation, and vascular invasion are important prognostic factors.