Liver - Original Article

Hepatocellular Carcinoma in Non-cirrhotic Liver Arises with a More Advanced Tumoral Appearance: A Single-Center Cohort Study

Volume 32 · Issue 8 Publish Date: August 15, 2021
Coşkun Özer Demirtaş Tuğba Tolu Çaglayan Keklikkıran Osman Cavit Özdoğan Feyza Gündüz
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Turkish Journal of Gastroenterology

Volume 32 · Issue 8

Pages: 685-693

History

Published Online: August 15, 2021

Copyright © 2021 Coşkun Özer Demirtaş, Tuğba Tolu, Çaglayan Keklikkıran, Osman Cavit Özdoğan, Feyza Gündüz

Coşkun Özer Demirtaş
Department of Gastroenterology, Marmara University School of Medicine, İstanbul, Turkey
Tuğba Tolu
Department of Internal Medicine, School of Medicine, Marmara University, Istanbul, Turkey
Çaglayan Keklikkıran
Department of Gastroenterology, School of Medicine, Marmara University, Istanbul, Turkey
Osman Cavit Özdoğan
GATA Haydarpaşa Eğitim Hastanesi Gastroenteroloji Servisleri, İstanbul
Feyza Gündüz
Covering the Cover Editor
Demirtaş, C. Özer, Tolu, T., Keklikkıran, Çaglayan, Özdoğan, O. C., & Gündüz, F. (2021). Hepatocellular Carcinoma in Non-cirrhotic Liver Arises with a More Advanced Tumoral Appearance: A Single-Center Cohort Study. Turkish Journal of Gastroenterology, 32(8), 685–693. https://doi.org/10.5152/tjg.2021.20677
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Abstract

Background: A small proportion of all hepatocellular carcinomas (HCCs) arise in a non-cirrhotic liver (NCL). However, our knowledge about the HCCs developing in a NCL is scarce. This study was undertaken to investigate the characteristics and survival course of this patient group. Methods: We retrospectively analyzed the database of patients with HCC at a tertiary center during a 10-year period (2009-2019). All demographic, clinical, laboratory, and tumoral features with survival outcomes were compared between the HCC-CL and HCC-NCL groups. Results: Out of 384 HCC cases, 11.2% (n = 43) had no cirrhosis. The dominant etiology in the HCC-NCL group was hepatitis B virus (n = 26, 60.5%), followed by non-alcoholic fatty liver disease (n = 10, 23.2%), and hepatitis C virus (n = 7, 16.3%). The maximum tumor diameter was approximately 2 times larger in the HCC-NCL group (HCC-NCL: 90 mm vs. HCC-CL: 46.5 mm, P < .001). The proportion of patients with vascular (HCC-NCL: 27.9% vs. HCC-CL: 8.6%, P < .001) and extrahepatic invasion (HCC-NCL: 14% vs. HCC-CL: 3%, P = .001) were prominently higher in the HCC-NCL group. Patients with HCC-NCL were less often detected in early-curable stages (BCLC 0-A) than those in the HCC-CL group (HCC-NCL: 16.3% vs. HCC-CL: 34.9%, P = .004). The overall survival was not different between the 2 groups (HCC-NCL: 19.4 ± 9.8 months vs. HCC-CL: 17.5 ± 2.3 months, P = .581). Conclusion: HCC in NCL is diagnosed at more advanced tumoral stages with larger tumor size and more often with vascular and extrahepatic spread. Despite the preserved liver functions, the overall survival is not prolonged in HCCs without cirrhosis, due to the late recognition.

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Article Info
Published In
Journal Turkish Journal of Gastroenterology
Volume / Issue Volume 32 · Issue 8
Pages 685-693
DOI 10.5152/tjg.2021.20677
History
Published Online August 15, 2021
Copyright
Copyright (c) 2021 Coşkun Özer Demirtaş, Tuğba Tolu, Çaglayan Keklikkıran, Osman Cavit Özdoğan, Feyza Gündüz
Affiliations
Coşkun Özer Demirtaş
Department of Gastroenterology, Marmara University School of Medicine, İstanbul, Turkey
Tuğba Tolu
Department of Internal Medicine, School of Medicine, Marmara University, Istanbul, Turkey
Çaglayan Keklikkıran
Department of Gastroenterology, School of Medicine, Marmara University, Istanbul, Turkey
Osman Cavit Özdoğan
GATA Haydarpaşa Eğitim Hastanesi Gastroenteroloji Servisleri, İstanbul
Feyza Gündüz
Covering the Cover Editor
Cite this Article
Demirtaş, C. Özer, Tolu, T., Keklikkıran, Çaglayan, Özdoğan, O. C., & Gündüz, F. (2021). Hepatocellular Carcinoma in Non-cirrhotic Liver Arises with a More Advanced Tumoral Appearance: A Single-Center Cohort Study. Turkish Journal of Gastroenterology, 32(8), 685–693. https://doi.org/10.5152/tjg.2021.20677
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