Comparative analysis of liver resection in Non-B Non-C and hepatitis virus-associated hepatocellular carcinoma

Takeshi Takamoto; Satoshi Nara; Daisuke Ban; Takahiro Mizui; Masami Mukai; Esaki Minoru; Kazuaki Shimada

doi:10.1016/j.ejso.2024.108381

Comparative analysis of liver resection in Non-B Non-C and hepatitis virus-associated hepatocellular carcinoma

Eur J Surg Oncol. 2024 May 1;50(7):108381. doi: 10.1016/j.ejso.2024.108381. Online ahead of print.

Authors

Takeshi Takamoto¹, Satoshi Nara², Daisuke Ban², Takahiro Mizui², Masami Mukai³, Esaki Minoru², Kazuaki Shimada²

Affiliations

¹ Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital, Tokyo, Japan. Electronic address: ttakamot@ncc.go.jp.
² Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital, Tokyo, Japan.
³ Department of Medical Informatics, National Cancer Center Hospital, Japan.

PMID: 38728963
DOI: 10.1016/j.ejso.2024.108381

Abstract

Background: The incidence of non-hepatitis B and non-hepatitis C hepatocellular carcinoma (NBNC-HCC) is increasing in our country. This study assesses the feasibility of employing an identical surgical treatment strategy for resectable NBNC-HCC as that for hepatitis virus-associated HCC (HV-HCC).

Methods: A retrospective analysis (1993-2023) of 1321 curative liver resections for HCC at a single institution was performed. Propensity score matching ensured a balanced comparison of preoperative clinical factors, including tumor status and background liver condition.

Results: The proportion of NBNC-HCC cases has gradually increased, reaching up to 70 %. After matching, 294 of 473 NBNC-HCC patients and 294 of 848 HV-HCC patients were compared. Operative outcomes, including operation time, blood loss, type of surgical procedure, and morbidity, were comparable. Long-term outcome analysis showed similar recurrence-free survival (HR: 0.86, 95 % CI: 0.70-1.06, P = 0.167) and overall survival (HR: 0.98, 95 % CI: 0.79-1.23, P = 0.865) for NBNC-HCC. Multivariable analysis identified ICGR15 ≥ 15 %, ALBI grade 2 or 3, aspartate aminotransferase ≥40, tumor size > 5 cm, multiple tumors, macrovascular invasion, and microvascular invasion as independent prognostic factors for overall survival, while hepatitis B or C virus status lost significance.

Conclusions: Despite the increasing incidence of NBNC-HCC, comparable outcomes were achieved between the two groups of matched cohort.

Keywords: Hepatitis virus; Hepatocellular carcinoma; Liver resection; Non-B non-C.