Background/Aim The profile of patients with hepatocellular carcinoma (HCC) has changed globally; the role of etiology in predicting prognosis of HCC patients remains unclear. We aimed to analyze the characteristics and prognosis of Korean patients with HCC according to disease etiology.
Methods This retrospective observational study included patients diagnosed with HCC between 2010 and 2014 in a single center in Korea. Patients with HCC aged <19 years old, had coinfection with other viral hepatitis, had missing follow-up data, were Barcelona Clinic Liver Cancer stage D, or died before 1 month were excluded.
Results A total of 1,595 patients with HCC were analyzed; they were classified into the hepatitis B virus (HBV) group (1,183 [74.2%]), hepatitis C virus (HCV) group (146 [9.2%]), and non-B non-C (NBNC) group (266 [16.7%]). The median overall survival of all patients was 74 months. The survival rates at 1, 3, and 5 years were 78.8%, 62.0% and 54.9% in the HBV group; 86.0%, 64.0%, and 48.6% in the HCV group; and 78.4%, 56.5%, and 45.9% in the NBNC group, respectively. NBNC-HCC has a poorer prognosis than other causes of HCC. Survival was significantly longer in the HBV group with early-stage HCC than in the NBNC group. Furthermore, survival was shorter in patients with early-stage HCC and diabetes mellitus (DM) than in those without DM.
Conclusions The etiology of HCC affected clinical characteristics and prognosis to some extent. NBNC-HCC patients showed shorter overall survival than viral-related HCC patients. Additionally, the presence of DM is an additional important prognostic factor in patients with early-stage HCC.
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Parasternal abscess is usually related to cardiac surgery, trauma or IV drug use and curable with antibiotics and surgical drainage. Sternal metastasis or primary parasternal abscess in a patient with hepatocellular carcinoma (HCC) is much rare and the differentiation between two diseases is occasionally difficult. Herein, we report a patient with HCC, diabetes mellitus and a spontaneously occurred parasternal abscess that is initially confused with a sternal metastasis. A-57-year-old man was admitted due to a slowly growing parasternal mass for 2 months. Two years prior to the admission, he had been diagnosed with small (1.6 cm) HCC in segment VII related to chronic hepatitis Band liver cirrhosis and treated with radiofrequency thermal ablation (RFTA). One year after RFTA, small (1.7 cm) HCC recurred in segment I and then he received TACE twiceat interval of 2 months. Eight months after that, multinodular HCCs newly developed in segment V and VIII (TNM stage IIIA) and two times of additional TACE were given. Thereafter he complained of gradually protruding mass with focal redness and mild tenderness on the sternum. But he denied any febrile and chilling sensation. Dynamic CT scans showed an enhanced parasternal lesion with bone destruction, while a bone scan displayed an increased uptake in the same site, resulting in an indistinguishable lesion between an abscess and a sternal metastasis of HCC. An excisional biopsy was performed on the lesion and revealed an abscess with sternal osteomyelitis rather than sternal metastasis. It was cured with surgical excision and antibiotics without complications.