Fibrosis in non-cancerous tissue is the unique prognostic factor for primary hepatocellular carcinoma without hepatitis B or C viral infection.

Abstract

The relationship between the state of non-cancerous tissues in patients with hepatocellular carcinoma (HCC) who are negative for hepatitis B surface antigen (HBsAg), hepatitis B core antibody (HBcAb), and hepatitis C antibody (HCVAb) (NBNC-HCC) and the prognosis has not yet been resolved. We examined the clinicopathological features of these patients and performed statistical analysis for the prognosis of recurrence following curative hepatic resection. Disease-free survival (DFS) revealed that only the degree of fibrosis was a significant prognostic factor (P = 0.0374). On the basis of the degree of fibrosis (New Inuyama Classification), patients with NBNC-HCC were divided into a non-fibrotic liver group (NF group; F0, n = 10) and a fibrotic liver group (FL group; F1-4, n = 34). The DFS rate in the NF group was significantly better than that in the FL group (P = 0.0408). In the NF group, only one patient recurred, while in the FL group, 21 patients had recurrences. In the FL group, intra-hepatic recurrence was frequently seen in both lobes within 2 years after the initial hepatic resection, while recurrences more than 2 years after the initial operation were mainly seen in the contralateral lobe. Histological assessment of the degree of fibrosis in the non-cancerous regions of NBNC-HCC may be useful not only for the selection of the appropriate treatment but also for the prediction of postoperative prognosis.