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Clinicopathological and prognostic features in patients who had undergone hepatectomy for hepatocellular carcinoma (HCC) were examined in relation to viral infection. Among 175 patients, cirrhosis was diagnosed histologically in 134, while 41 had noncirrhotic livers. One hundred twenty-four patients were positive for antibody to hepatitis C virus (anti-HCV) (HC group), 32 for hepatitis B virus surface antigen (HBsAg) (HB group), and 19 negative for both anti-HCV and HBsAg (non-B, non-C group). In the HB group, the mean patient age was significantly younger, and liver function in terms of the plasma retention rate of indocyanine green at 15 minutes and the serum total bilirubin level was significantly better than in either the HC or the non-B, non-C group. Seventeen patients had synchronous multicentric HCCs: the HC group showing a significantly higher incidence than the HB group (P < .05). In the HC group, the proportion of cirrhotic liver in patients with multicentric HCCs was significantly larger than in patients with unicentric HCC (P < .05). No significant differences in disease-free survival rate after hepatectomy were observed between the three groups. The present retrospective study of surgically treated patients showed that anti-HCV-positive HCCs tended to occur in older individuals who showed worse liver function and a higher incidence of cancer multicentricity compared with HBsAg-positive HCCs. The prognosis of anti-HCV-positive HCCs, which had the disadvantageous characteristic of multicentricity, did not differ from that of HBsAg-positive HCCs.
Shinichi Miyagawa (1996) studied this question.