Outcomes Following Resection of Hepatocellular Carcinoma in the Absence of Cirrhosis

Richard H. Lewis, Evan Glazer, David M. Bittenbinder, Thomas O’Brien, Jeremiah Deneve, David Shibata, Stephen W. Behrman, Jason M. Vanatta, Sanjaya Satapathy, Paxton V. Dickson

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalJournal of Gastrointestinal Cancer
DOIs
StateAccepted/In press - Jan 1 2018

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Hepatocellular Carcinoma
Fibrosis
Survival
Alkaline Phosphatase
Recurrence
Neoplasms
Capsules
Blood Vessels
Hepatectomy
Survival Rate
Obesity

All Science Journal Classification (ASJC) codes

  • Oncology
  • Gastroenterology

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Outcomes Following Resection of Hepatocellular Carcinoma in the Absence of Cirrhosis. / Lewis, Richard H.; Glazer, Evan; Bittenbinder, David M.; O’Brien, Thomas; Deneve, Jeremiah; Shibata, David; Behrman, Stephen W.; Vanatta, Jason M.; Satapathy, Sanjaya; Dickson, Paxton V.

In: Journal of Gastrointestinal Cancer, 01.01.2018.

Research output: Contribution to journalArticle

Lewis, Richard H. ; Glazer, Evan ; Bittenbinder, David M. ; O’Brien, Thomas ; Deneve, Jeremiah ; Shibata, David ; Behrman, Stephen W. ; Vanatta, Jason M. ; Satapathy, Sanjaya ; Dickson, Paxton V. / Outcomes Following Resection of Hepatocellular Carcinoma in the Absence of Cirrhosis. In: Journal of Gastrointestinal Cancer. 2018.
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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.",
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AU - Lewis, Richard H.

AU - Glazer, Evan

AU - Bittenbinder, David M.

AU - O’Brien, Thomas

AU - Deneve, Jeremiah

AU - Shibata, David

AU - Behrman, Stephen W.

AU - Vanatta, Jason M.

AU - Satapathy, Sanjaya

AU - Dickson, Paxton V.

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N2 - 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.

AB - 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.

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