Impact of Viral Etiology on Postoperative De Novo Recurrence After Hepatectomy for Hepatocellular Carcinoma in Cirrhotic Patients

Kazunari Sasaki, Junichi Shindoh, Yujiro Nishioka, Georgios A. Margonis, Toshitaka Sugawara, Nikolaos Andreatos, Masaji Hashimoto, Timothy M. Pawlik

Research output: Contribution to journalArticle

Abstract

Background and Aim: Liver cirrhosis (LC) and hepatocellular carcinoma (HCC) are associated with viral hepatitis, especially hepatitis B virus (HBV) and hepatitis C virus (HCV). Whether differences exist in postoperative de novo carcinogenesis from established cirrhosis according to viral etiology remains unclear. Methods: Data from 313 LC patients with viral hepatitis (HBV-LC, n = 108 and HCV-LC, n = 205) who underwent curative-intent hepatectomy for HCC were retrospectively collected. Clinicopathological characteristics, cumulative recurrence, chronological change of recurrence rate, and predictors of recurrence were analyzed. Results: Baseline patient characteristics were different among patients with HBV versus HCV as HCC-LC patients had a lower albumin, higher alanine transaminase, and higher incidence of tumor multicentricity (all P < 0.050). The 1-, 3-, and 5-year cumulative recurrence was 16.7, 38.6, and 53.7% in HBV-LC versus 20.8, 52.2, and 71.6% in HCV-LC (P = 0.002) patients, respectively. The postoperative annual recurrence rates of HCV-LC were consistently higher than that of HBV-LC patients. After matching on clinicopathologic characteristics, while recurrence was comparable in the early time period, HCV-LC patients had a 2–5% higher incidence of recurrence compared with HBV-LC patients after 20 months post-resection. On multivariable analysis, HCV infection was an independent predictor of recurrence (HR 1.55; 95% CI 1.13–2.13). Conclusion: HCV-related LC was associated with a higher postoperative de novo carcinogenesis than HBV-related LC. Establishment of different treatment algorithms as well as follow-up surveillance protocols stratified by viral etiology may be warranted.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalJournal of Gastrointestinal Surgery
DOIs
StateAccepted/In press - Jan 3 2017

Fingerprint

Hepatectomy
Liver Cirrhosis
Hepatocellular Carcinoma
Recurrence
Hepacivirus
Hepatitis B virus
Hepatitis
Carcinogenesis
Incidence
Virus Diseases
Alanine Transaminase
Albumins
Fibrosis

Keywords

  • Hepatectomy
  • Hepatitis B virus
  • Hepatitis C virus
  • Hepatocellular carcinoma
  • Liver cirrhosis

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Impact of Viral Etiology on Postoperative De Novo Recurrence After Hepatectomy for Hepatocellular Carcinoma in Cirrhotic Patients. / Sasaki, Kazunari; Shindoh, Junichi; Nishioka, Yujiro; Margonis, Georgios A.; Sugawara, Toshitaka; Andreatos, Nikolaos; Hashimoto, Masaji; Pawlik, Timothy M.

In: Journal of Gastrointestinal Surgery, 03.01.2017, p. 1-9.

Research output: Contribution to journalArticle

Sasaki, Kazunari ; Shindoh, Junichi ; Nishioka, Yujiro ; Margonis, Georgios A. ; Sugawara, Toshitaka ; Andreatos, Nikolaos ; Hashimoto, Masaji ; Pawlik, Timothy M. / Impact of Viral Etiology on Postoperative De Novo Recurrence After Hepatectomy for Hepatocellular Carcinoma in Cirrhotic Patients. In: Journal of Gastrointestinal Surgery. 2017 ; pp. 1-9.
@article{ab5ff787533e4bb9a4e0a07dc32605e6,
title = "Impact of Viral Etiology on Postoperative De Novo Recurrence After Hepatectomy for Hepatocellular Carcinoma in Cirrhotic Patients",
abstract = "Background and Aim: Liver cirrhosis (LC) and hepatocellular carcinoma (HCC) are associated with viral hepatitis, especially hepatitis B virus (HBV) and hepatitis C virus (HCV). Whether differences exist in postoperative de novo carcinogenesis from established cirrhosis according to viral etiology remains unclear. Methods: Data from 313 LC patients with viral hepatitis (HBV-LC, n = 108 and HCV-LC, n = 205) who underwent curative-intent hepatectomy for HCC were retrospectively collected. Clinicopathological characteristics, cumulative recurrence, chronological change of recurrence rate, and predictors of recurrence were analyzed. Results: Baseline patient characteristics were different among patients with HBV versus HCV as HCC-LC patients had a lower albumin, higher alanine transaminase, and higher incidence of tumor multicentricity (all P < 0.050). The 1-, 3-, and 5-year cumulative recurrence was 16.7, 38.6, and 53.7{\%} in HBV-LC versus 20.8, 52.2, and 71.6{\%} in HCV-LC (P = 0.002) patients, respectively. The postoperative annual recurrence rates of HCV-LC were consistently higher than that of HBV-LC patients. After matching on clinicopathologic characteristics, while recurrence was comparable in the early time period, HCV-LC patients had a 2–5{\%} higher incidence of recurrence compared with HBV-LC patients after 20 months post-resection. On multivariable analysis, HCV infection was an independent predictor of recurrence (HR 1.55; 95{\%} CI 1.13–2.13). Conclusion: HCV-related LC was associated with a higher postoperative de novo carcinogenesis than HBV-related LC. Establishment of different treatment algorithms as well as follow-up surveillance protocols stratified by viral etiology may be warranted.",
keywords = "Hepatectomy, Hepatitis B virus, Hepatitis C virus, Hepatocellular carcinoma, Liver cirrhosis",
author = "Kazunari Sasaki and Junichi Shindoh and Yujiro Nishioka and Margonis, {Georgios A.} and Toshitaka Sugawara and Nikolaos Andreatos and Masaji Hashimoto and Pawlik, {Timothy M.}",
year = "2017",
month = "1",
day = "3",
doi = "10.1007/s11605-016-3344-3",
language = "English (US)",
pages = "1--9",
journal = "Journal of Gastrointestinal Surgery",
issn = "1091-255X",
publisher = "Springer New York",

}

TY - JOUR

T1 - Impact of Viral Etiology on Postoperative De Novo Recurrence After Hepatectomy for Hepatocellular Carcinoma in Cirrhotic Patients

AU - Sasaki, Kazunari

AU - Shindoh, Junichi

AU - Nishioka, Yujiro

AU - Margonis, Georgios A.

AU - Sugawara, Toshitaka

AU - Andreatos, Nikolaos

AU - Hashimoto, Masaji

AU - Pawlik, Timothy M.

PY - 2017/1/3

Y1 - 2017/1/3

N2 - Background and Aim: Liver cirrhosis (LC) and hepatocellular carcinoma (HCC) are associated with viral hepatitis, especially hepatitis B virus (HBV) and hepatitis C virus (HCV). Whether differences exist in postoperative de novo carcinogenesis from established cirrhosis according to viral etiology remains unclear. Methods: Data from 313 LC patients with viral hepatitis (HBV-LC, n = 108 and HCV-LC, n = 205) who underwent curative-intent hepatectomy for HCC were retrospectively collected. Clinicopathological characteristics, cumulative recurrence, chronological change of recurrence rate, and predictors of recurrence were analyzed. Results: Baseline patient characteristics were different among patients with HBV versus HCV as HCC-LC patients had a lower albumin, higher alanine transaminase, and higher incidence of tumor multicentricity (all P < 0.050). The 1-, 3-, and 5-year cumulative recurrence was 16.7, 38.6, and 53.7% in HBV-LC versus 20.8, 52.2, and 71.6% in HCV-LC (P = 0.002) patients, respectively. The postoperative annual recurrence rates of HCV-LC were consistently higher than that of HBV-LC patients. After matching on clinicopathologic characteristics, while recurrence was comparable in the early time period, HCV-LC patients had a 2–5% higher incidence of recurrence compared with HBV-LC patients after 20 months post-resection. On multivariable analysis, HCV infection was an independent predictor of recurrence (HR 1.55; 95% CI 1.13–2.13). Conclusion: HCV-related LC was associated with a higher postoperative de novo carcinogenesis than HBV-related LC. Establishment of different treatment algorithms as well as follow-up surveillance protocols stratified by viral etiology may be warranted.

AB - Background and Aim: Liver cirrhosis (LC) and hepatocellular carcinoma (HCC) are associated with viral hepatitis, especially hepatitis B virus (HBV) and hepatitis C virus (HCV). Whether differences exist in postoperative de novo carcinogenesis from established cirrhosis according to viral etiology remains unclear. Methods: Data from 313 LC patients with viral hepatitis (HBV-LC, n = 108 and HCV-LC, n = 205) who underwent curative-intent hepatectomy for HCC were retrospectively collected. Clinicopathological characteristics, cumulative recurrence, chronological change of recurrence rate, and predictors of recurrence were analyzed. Results: Baseline patient characteristics were different among patients with HBV versus HCV as HCC-LC patients had a lower albumin, higher alanine transaminase, and higher incidence of tumor multicentricity (all P < 0.050). The 1-, 3-, and 5-year cumulative recurrence was 16.7, 38.6, and 53.7% in HBV-LC versus 20.8, 52.2, and 71.6% in HCV-LC (P = 0.002) patients, respectively. The postoperative annual recurrence rates of HCV-LC were consistently higher than that of HBV-LC patients. After matching on clinicopathologic characteristics, while recurrence was comparable in the early time period, HCV-LC patients had a 2–5% higher incidence of recurrence compared with HBV-LC patients after 20 months post-resection. On multivariable analysis, HCV infection was an independent predictor of recurrence (HR 1.55; 95% CI 1.13–2.13). Conclusion: HCV-related LC was associated with a higher postoperative de novo carcinogenesis than HBV-related LC. Establishment of different treatment algorithms as well as follow-up surveillance protocols stratified by viral etiology may be warranted.

KW - Hepatectomy

KW - Hepatitis B virus

KW - Hepatitis C virus

KW - Hepatocellular carcinoma

KW - Liver cirrhosis

UR - http://www.scopus.com/inward/record.url?scp=85008195190&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85008195190&partnerID=8YFLogxK

U2 - 10.1007/s11605-016-3344-3

DO - 10.1007/s11605-016-3344-3

M3 - Article

C2 - 28050767

AN - SCOPUS:85008195190

SP - 1

EP - 9

JO - Journal of Gastrointestinal Surgery

JF - Journal of Gastrointestinal Surgery

SN - 1091-255X

ER -