Synapse - Hepatocellular carcinoma in patients with no identifiable risk factors

Hepatocellular carcinoma in patients with no identifiable risk factors Journal Article

Authors:	McIntyre, C. A.; Chou, J. F.; Gonen, M.; Shia, J.; Gambarin-Gelwan, M.; Balachandran, V. P.; Kingham, T. P.; Allen, P. J.; Drebin, J. A.; Jarnagin, W. R.; D'Angelica, M. I.
Article Title:	Hepatocellular carcinoma in patients with no identifiable risk factors
Abstract:	Background: A subset of patients have no risk factors for the development of hepatocellular carcinoma (HCC). We evaluated differences in clinical variables between patients with and without risk factors who underwent surgical resection. Methods: A prospectively maintained database was queried for patients who underwent R0/R1 resection of HCC between 1992 and 2016. Risk factors included HCV, HBV, hemochromatosis, alcoholic liver disease, or cirrhosis, stage 2 or 3 fibrosis or severe (>66%) steatosis of the non-neoplastic liver. Variables were compared between patients with and without risk factors. Results: There were 416 patients who underwent resection; 276 (66%) had known risk factors while 140 (34%) did not. Patients without risk factors were more likely to be older, female and have hyperlipidemia or coronary artery disease (p < 0.004). These patients had larger tumors and were more likely to undergo major hepatectomy (p < 0.001). There was no difference in OS (5-year, 56% vs 47%, p = 0.335), RFS (27% vs 24%, p = 0.398), or the rates of intrahepatic (HR:1.16 [95%CI:0.95–1.57], p = 0.344) and extrahepatic recurrences (HR:0.72 [95%CI:0.4–1.3], p = 0.261) between groups. Conclusion: Patients without risk factors for HCC presented with larger tumors yet had similar outcomes, suggesting these tumors may represent a different disease process, and underlying liver dysfunction can influence overall outcome. © 2020 International Hepato-Pancreato-Biliary Association Inc.
Keywords:	adult; controlled study; aged; major clinical study; overall survival; hepatitis b; hepatitis c; liver cell carcinoma; tumor volume; retrospective study; risk factor; sex ratio; age; tumor recurrence; comorbidity; liver resection; metabolic syndrome x; coronary artery disease; hyperlipidemia; recurrence free survival; human; male; female; article
Journal Title:	HPB
Volume:	23
Issue:	1
ISSN:	1365-182X
Publisher:	Elsevier Science, Inc.
Date Published:	2021-01-01
Start Page:	118
End Page:	126
Language:	English
DOI:	10.1016/j.hpb.2020.05.005
PUBMED:	32591247
PROVIDER:	scopus
PMCID:	PMC8022289
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85086862362&doi=10.1016%2fj.hpb.2020.05.005&partnerID=40&md5=b438168cdaf832e1706324726ae44939
Notes:	Article -- Export Date: 1 March 2021 -- Source: Scopus