CAJ | 학술논문

BACKGROUND:?The?global?risk?of?hepatocellular?carcinoma?(HCC)?is?largely?due?to?hepatitis?B?virus?(HBV)?and?hepatitis?C?virus?(HCV)?infections.?In?recent?years,?however,?an?increased?prevalence?of?non-viral?HCC?has?been?noted.?The?clinical?impact?of?the?presence/absence?of?viral?infections?in?HCC?remains?controversial.?The?present?study?aimed?to?assess?the?effect?of?hepatitis?viruses?on?demographics,?clinical?and?pathological?features?and?long-term?outcome?in?a?large?cohort?of?Romanian?patients?who?underwent?surgery?for?HCC. <br> METHODS:?The?study?included?404?patients?with?HCC?who?had?undergone?resection,?transplantation?or?radiofrequency?ablation?at?a?single?institution?between?2001?and?2010.?The?patients?were?divided?into?four?groups:?85?patients?with?hepatitis?B?virus?infection?(HBV?group),?164?patients?with?hepatitis?C?virus?infection?(HCV?group),?39?patients?with?hepatitis?B?and?C?virus?co-infection?(HBCV?group),?and?116?patients?without?viral?infection?(non-BC?group). <br> RESULTS:?The?patients?of?both?HBV?(56.0±11.3?years)?and?HBCV?groups?(56.0±9.9?years)?were?signiifcantly?younger?than?those?of?the?HCV?(61.0±8.5?years,?P=0.001)?and?non-BC?groups?(61.0±13.0?years,?P=0.002).?Interestingly,?the?prevalence?of?liver?cirrhosis?was?signiifcantly?lower?in?the?non-BC?group?(47%)?than?in?any?other?subsets?(72%-90%,?P<0.002).?Furthermore,?the?non-BC?patients?were?more?advanced?according?to?the?Barcelona?Clinic?Liver?Cancer?stages?than?the?patients?of?the?HCV?or?HBCV?groups?(P<0.020);?accordingly,?they?were?more?frequently?assessed?beyond?the?Milan?criteria?than?any?other?groups?(P=0.001).?No?signiifcant?differences?in?the?disease-free?or?overall?survival?rates?were?observed?among?these?groups. <br> CONCLUSIONS:?Patients?with?non-viral?HCC?are?diagnosed?at?advanced?ages?and?stages,?a?situation?plausibly?due?to?the?poor?effectiveness?of?cancer?surveillance?in?community?practice.?The?presence?of?viral?infections?does?not?appear?to?impair?the?long-term?prognosis?after?surgical?treatment?in?patients?with?HCC;?however,?there?is?a?trend?for?worse?disease-free?survival?rates?in?HBCV?patients,?though?statistical?signiifcance?was?not?reached.