Journal of Liver Cancer

Original Article

Incidence and Clinical Features of Hepatitis C Virus-associated Hepatocellular Carcinoma Patients without Liver Cirrhosis in Hepatitis B Virus-endemic Area: Jongbeom Shin, Jung Hwan Yu, Young-Joo Jin, Jin-Woo Lee; J Liver Cancer. 2021;21(1):34-44. Published online March 31, 2021; DOI: https://doi.org/10.17998/jlc.21.1.34

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Background
/objective: Hepatitis C virus (HCV)-associated hepatocellular carcinoma (HCC) is rarely observed in patients without liver cirrhosis (LC). We evaluated the incidence and clinical feature of HCV-associated HCC patients with or without LC.
Methods
The medical records of 1,516 patients diagnosed as having primary HCC at our hospital between January 2005 and December 2017 were retrospectively reviewed. Of these, 154 (10.2%) HCV-associated HCC patients were analyzed. LC was diagnosed histologically or clinically.
Results
Seventeen (11.0%) of the 154 patients had non-cirrhotic HCC, and all were of Child-Turcotte-Pugh (CTP) class A, Among the 17 patients, 88.2% were male, all had nodular type HCC, and only 2 (11.8%) were under HCC surveillance. Median overall survival (OS) of HCV-associated HCC patients with and without LC was 15 months and 37 months, respectively. Cumulative OS rates were not different between non-cirrhotic patients and cirrhotic patients with CTP class A (P=0.229). Cumulative OS rates were significantly higher in non-cirrhotic patients than in cirrhotic patients of CTP class B (P<0.001) or C (P<0.001). Multivariate analyses showed serum AST (hazard ratio [HR] 1.01, P=0.003) and AFP levels (HR 1.01, P=0.016), antiviral therapy (HR 0.25, P=0.022), and LC of CTP class B (HR, 5.24, P=0.006) or C (HR 21.79, P<0.001) were significantly associated with prognosis in HCV-associated HCC patients.
Conclusions
HCC in a non-cirrhotic liver was found in 11% of HCV-associated HCC patients. OSs of HCV-associated HCC patients were better in those of CTP A, regardless of LC than in those with LC of CTP class B or C.

Citations

Citations to this article as recorded by

Serological Biomarkers Related to Non-Cirrhotic Hepatocellular Carcinoma: Promising Applications in Clinical Diagnosis and Prognosis
进玲刘
Advances in Clinical Medicine.2025; 15(02): 142. CrossRef
LI-RADS for Diagnosing Hepatocellular Carcinoma in Patients with Noncirrhotic Chronic Hepatitis C
Jihyun An, Rohee Park, Euichang Kim, Seong Kyun Na, Ha Il Kim, In-Hye Song, Young Seo Cho, Ji Hun Kang, Han Chu Lee, Seungbong Han, Jean-Charles Nault, Sang Hyun Choi, Ju Hyun Shim
Radiology.2025;[Epub] CrossRef
Comparison of Surgical Resection and Radiofrequency Ablation in Elderly Patients with Hepatocellular Carcinoma
Jun Il Kim, Jayoun Lee, Gi Hong Choi, Min Woo Lee, Dong Ah Park, Jeong-Ju Yoo
Digestive Diseases and Sciences.2024; 69(3): 1055. CrossRef
Diagnostic performance of CT/MRI LI-RADS v2018 in non-cirrhotic hepatitis C virus infection
Jennie J. Cao, Andy Shon, Luke Yoon, Aya Kamaya, Justin R. Tse
Abdominal Radiology.2024; 50(4): 1615. CrossRef

Review Article

Nutrition and Management of Hepatic Encephalopathy: Jin-Woo Lee; Journal of the Korean Liver Cancer Study Group. 2012;12(2):120-127. Published online September 30, 2012

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Abstract PDF: It has been estimated that at least 25% of patients with liver cirrhosis experience hepatic encephalopathy during the natural history of the disease. Hepatic encephalopathy is more frequent in patients with more severe liver disease. Also, malnutrition is common in patients with liver cirrhosis, and is considered a significant prognostic factor affecting quality of life, outcome, and survival. Inadequate intake of nutrients, the hypermetabolic state, the diminished synthetic capacity of the liver and the impaired absorption of nutrients are themain reasons that disrupt the metabolic balance in cirrhosis. In the general approach to cirrhotic patients, the initial and most important step for the clinician is to recognize the extent of malnutrition. Unfortunately, the Child-Pugh-Turcotte classification and the model for end-stage liver disease (MELD) do not include an assessment of nutritional status in spite of the fact that malnutrition plays an important role in morbidity and mortality in end-stage liver failure. To date, the practice of dietary protein restriction for patients with liver cirrhosis is deeply embedded among medical practitioners and dietitians. However, the negative effects of protein restriction are clear, that is, increased protein catabolism, the release of amino acids from the muscle, and possible worsening of hepatic encephalopathy. Nutritional support with sufficient protein requirements, antioxidants, vitamins as well as probiotics may improve nutritional status, liver function, and hepatic encephalopathy in patients with liver cirrhosis.

Case Report

A Small Hepatocellular Carcinoma Invading the Intrahepatic Duct Confirmed by Percutaneous Transhepatic Cholangioscopy: Byoung Wook Bang, Seok Jeong, Yong Sun Jeon, In Suh Park, Don Haeng Lee, Jung Il Lee, Kye Sook Kwon, Hyung Gil Kim, Yong Woon Shin, Young Soo Kim, Jin-Woo Lee; Journal of the Korean Liver Cancer Study Group. 2008;8(1):74-76. Published online June 30, 2008

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Abstract PDF: A hepatocellular carcinoma (HCC) invading the bile duct is an uncommon form and sometimes difficult to differentiate from cholangiocarcinoma. Because of different treatment modality, differential diagnosis of thesetwo diseases should be performed. We experienced an unusual case with HCC with obstructive jaundice caused by the involvement of intrahepatic duct, then confirmed by percutaneous transhepatic cholangioscopic biopsy results. A 60-year-old man was admitted with fever, chills, and an epigastric pain of 5 days duration. The patient had compensated liver cirrhosis as a result of alcohol abuse. Multidetector computed tomography (MDCT) of the abdomen revealed a low attenuated mass associated with bile duct dilation at the fourth segment of the liver. The cholangioscopic finding showed a single, 2-cm, polypoid mass with a yellowish ‘‘chicken fat-like’’ appearance, protruding into the lumen of the fourth branch of the left intrahepatic duct and bleeding easily. A diagnosis of HCC was proven by microscopic examination of the tissue specimen obtained by a cholangioscopic biopsy.

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