Hepatoma in the noncirrhotic liver

Abstract

The pathologic features, clinical presentation and natural history of hepatocellular carcinoma (HCC) developing in the noncirrhotic liver were studied in 61 patients against a background of 63 patients seen concurrently with HCC complicating cirrhosis. Noncirrhotic HCC had a bimodal age distribution, with females predominating the first age-clustering (10-50 years) and males predominating the second age-clustering (50-90 years). Cirrhotic HCC had a unimodal age distribution (40-90 years) with male dominance throughout. Estrogen exposure was noted in 57% of the noncirrhotic HCC women overall and in 80% of those in the younger age-clustering. The majority of noncirrhotic HCC presented with a single hepatic mass or a dominant primary with satellite lesions in contrast to the usual multinodular or diffuse disease seen with cirrhosis. Twenty-nine noncirrhotic patients survived complete resection of disease limited to the liver and exhibited a median survival of 2.7 years with a 5-year survival of 25%. Low histologic grade, minimal necrosis, and the absence of hemoperitoneum, hepatomegaly, and adjacent organ involvement were all favorable prognostic variable. Patients with metastatic or locally unresectable noncirrhotic HCC had a median survival of 9 months, and 24% survived in excess of 2 years. This survival experience is significantly more favorable than cirrhotic HCC patients, who had only a 1.2-month median and a 3% 2-year survival. Low histologic grade, mild mitotic activity and the presence of some fibrosis within the specimen were associated with a favorable outcome in advanced noncirrhotic HCC. The favorable prognosis and heterogeneous composition of the noncirrhotic, when compared to the cirrhotic HCC cohort, may be important considerations in the design and evaluation of future clinical trials.

Effectiveness of periodic checkup by ultrasonography for the early diagnosis of hepatocellular carcinoma

“…Based on the age-specific and sexspecific liver cancer mortality rates in Japan (1978)," we included only cases of chronic hepatitis in men 40 years or older and in women 50 years or older as the age groups having a liver cancer mortality rate of more than five persons per 100,000 population. As a result, we were able to detect liver cancer at a rate sufficiently high for mass screening i.e., 9.6% among liver cirrhosis cases and 1% among chronic hepatitis cases, with a 5 5% indication for surgical resection. The examination reported here was conducted as a pilot study, and the subjects of the study were selected from patients visiting our hospital for examination.…”

Place of liver transplantation in the treatment of hepatocellular carcinoma in the normal liver

“…Liver Resection [7][8][9][10][11][12][13][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] (Table 1) The articles reviewed for information on partial liver resection for NC-HCC include 2263 patients; the numbers of patients in these series range from 20 to 254. [7][8][9][10][11][12][13][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] The results of the French multicenter ...…”

“…[7][8][9][10][11][12][13][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] The results of the French multicenter study, 1 which includes the world's largest series of resections for HCC arising in normal livers (ie, nonfibrotic and noncirrhotic), are discussed separately. The larger studies come from regions with high rates of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections.…”

Spontaneous regression of hepatocellular carcinoma confirmed by surgical specimen: report of two cases and review of the literature

“…Similarly, in spite of a positive correlation, the influence of tumor size, degree of differentiation, AFP titer, hepatitis [37,41,42], exceptions of HCC in the non-cirrhotic liver [41,[43][44][45] or the degree of differentiation [41,44,46] is not clarified. However, a clinical course with septic fever and the accompanying changes in laboratory values that first may simulate liver abscess seem to be of great significance.…”