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Liver
Impact of viral hepatitis on the outcome of patients after curative resection of hepato cellular carcinoma
  1. R C Siriwardana *1,
  2. S T Fan1,
  3. C M Lo1,
  4. S C Chan1
  1. 1Surgery, University of Hong Kong, Hong Kong, China

Abstract

Introduction Hepatitis B (HBV) and C (HCV) viruses are closely linked with hepato cellular carcinoma (HCC). Virus induced tumour recurrence and hepatic parenchymal damage are major concerns after curative resection of HCC.

Methods 781 Patients who underwent curative resection of HCC were divided in to three groups according their viral status (HBV=656, HCV=28, none hepatitis = 98). The baseline features and the survival of the groups were compared. Further they were divided according to background liver status as cirrhotics and none cirrhotics. In two groups HBV positive and negative patients were compared on the baseline features and survival.

Results A higher number of HBV (56%, p<0.001) and HCV (78%, p<0.001) patients were cirrhotics and had poor liver function. None B/C patient's median disease free survival (DFS) of 21.5 months and overall survival (OS) of 72 months was similar to DFS of 19 months and OS of 66 months (p=0.8 and 0.9 respectively) in HBV patients. HCV patients also had a similar DFS (26 months, p=0.7) and OS (66 months, p=0.64).

When none cirrhotics (n=361) were taken separately, DFS in HBV positive cases was 18 months compared to 22 in others (p=0.68). On multivariate analysis HBV status was not affecting the OS (p=0.6) or DFS (p=0.6). In 393 cirrhotics, DFS was 18.5 months in HBV positive and 21.5 in none hepatitis patients (p=.0.5). The OS was 67.5 and 71 months in HBV and none hepatitis patients respectively (p=0.34). HBV status did not associate significantly with OS (p=0.3) or DFS (p=0.64).

In 270 cirrhotic patients who developed recurrence, the treatment offered for recurrence or subsequent survival did not differ between HBV positive and negative patients.

Conclusion Hepatitis B surface antigen positivity does not affect the recurrence, survival or the subsequent treatment of recurrence after curative resection of HCC.

  • hepatitis B
  • chronic/complications
  • hepatocellular carcinoma.

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Footnotes

  • Competing interests None.

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