Surgical results in patients with hepatitis virus-related hepatocellular carcinoma in Taiwan

To investigate the surgical results of hepatectomy for hepatocellular carcinoma in relation to hepatitis virus status in Taiwan, 252 patients (196 men and 56 women; March 1992 to August 1998) were reviewed. The patients were divided into four groups: 30 patients (11.9%) seronegative for both hepatitis B surface antigen (HBsAg) and antihepatitis C antibody (HCVAb) (N-HCC group); 133 patients (52.8%) seropositive for HBsAg and seronegative for HCVAb (B-HCC group); 66 patients (26.2%) seronegative for HBsAg and seropositive for HCVAb (C-HCC group); and 23 patients (9.1%) seropositive for both HBsAg and HCVAb (BC-HCC group). Patients in group C-HCC were older (p=0.001) and had a higher incidence of diabetes mellitus (p=0.004). Also, they had a higher indocyanine green retention rate at 15 minutes (p=0.021), longer international normalization ratio for the prothrombin time (p=0.049), and smaller tumor (p=0.006). Postoperative complications and hospital mortality were significantly higher in patients in the C-HCC and BC-HCC groups (p=0.046, 0.021). All patients were followed 12 to 76 months after hepatectomy (mean 23.5±16.3 months). The 1-, 3-, and 5-year overall cumulative survival rates of the 252 patients in this series were 80%, 54.3%, and 34.2%, respectively. The cumulative intrahepatic recurrence rates were 46.5%, 64.9%, and 72.9% at 1, 3, and 5 years, respectively. The mean disease-free survival time was longest in group C-HCC and shortest in group BC-HCC (p=0.020). The overall survival time and cumulative survival rates in the four groups were not significantly different (p=0.146).