Article Abstract

Clinical features and prognostic factors of cryptogenic hepatocellular carcinoma

Authors: Qichen Chen, Hong Zhao, Jianjun Zhao, Xinyu Bi, Zhiyu Li, Zhen Huang, Yefan Zhang, Jianguo Zhou, Jianqiang Cai

Abstract

Background: To explore the clinical features and prognostic factors of cryptogenic hepatocellular carcinoma (cHCC).
Methods: The clinical data of 59 cHCC patients who had undergone radical surgery in our center from February 1999 to December 2010 were retrospectively analyzed. Survival analysis was performed by using the Kaplan-Meier method. Univariate and multivariate regression analyses were carried out for the assessment of potential prognostic factors.
Results: Among these 59 patients, there were 49 men and 10 women aged 27 to 84 years (mean: 61.4 years). Sixteen patients (27.12%) had nonalcoholic fatty liver disease (NAFLD), whereas hepatitis virus serologic markers were not completely negative in 43 patients (72.88%; non-all-negative group). All patients received radical resection in our hospital. HCC was confirmed after postoperative pathologic examinations in all these 59 patients. Pathology revealed that 34 patients also had cirrhosis, and the manifestations of cirrhosis significantly differed between all-negative group and non-all-negative group. Forty-three patients (72.88%) died within follow-up. The postoperative 3- and 5-year survival rates were 44.07% and 35.59%, respectively. The longest disease-free survival after the operation was 195 months, and the median survival time was 32 months. Multivariate analysis showed that HBcAb (+) and NAFLD were independent prognostic factors for the postoperative survival of patients with cryptogenic HCC (HR =2.558, 95% CI: 1.146–5.711, P=0.022; HR =2.067, 95% CI: 1.056–4.049, P=0.034).
Conclusions: cHCC is a relatively rare disease and occurs mainly in elderly obese males. The development of cHCC is associated with NAFLD and hepatitis B virus Infection. HBcAb (+) status and NAFLD are independent prognostic factors for the postoperative survival of cHCC patients.