Po-Yao Hsu1, Cheng-Ting Hsu1, Ming-Lun Yeh1,2,3, Chung-Feng Huang1,2,3, Ching-I Huang1,2,3, Po-Cheng Liang1,2, Yi-Hung Lin1, Ming-Yen Hsieh1, Yu-Ju Wei1, Meng-Hsuan Hsieh1,3,4, Chia-Yen Dai1,2,3, Zu-Yau Lin1,3, Shinn-Cherng Chen1,3, Jee-Fu Huang5,6,7,8, Ming-Lung Yu1,2,3,9, Wan-Long Chuang1,2,3. 1. Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. 2. Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. 3. Faculty of Internal Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. 4. Department of Preventive Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. 5. Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. jfliver@kmu.edu.tw. 6. Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. jfliver@kmu.edu.tw. 7. Faculty of Internal Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. jfliver@kmu.edu.tw. 8. Centre for Liquid Biopsy and Cancer Research Centre, Kaohsiung Medical University, Kaohsiung, Taiwan. jfliver@kmu.edu.tw. 9. Centre for Liquid Biopsy and Cancer Research Centre, Kaohsiung Medical University, Kaohsiung, Taiwan.
Abstract
BACKGROUND AND AIMS: The features of non-viral, nonalcohol hepatocellular carcinoma (NBNC-HCC) remain elusive. The aim of this study was to investigate this clinical characteristics and overall survival of NBNC-HCC compared to hepatitis B- (HBV-HCC) and hepatitis C-related (HCV-HCC) HCC. METHODS: We analyzed the etiologies, fibrosis stages, clinical data, and outcomes of newly diagnosed patients with HCC. RESULTS: A total of 1777 HCC patients were recruited, including 332 patients with NBNC-HCC, 682 patients with HBV-HCC, 680 patients with HCV-HCC, and 83 patients with HBV/HCV HCC. Patients with NBNC-HCC were older (69.9 ± 11.9 years). Patients with NBNC-HCC exhibited a higher prevalence of diabetes (43.9%) compared to the HBV-HCC (27.1%, p < 0.05) and HCV-HCC (30.2%, p < 0.05) groups. Compared to patients from the viral-related HCC groups, patients with NBNC-HCC exhibited a significantly lower fibrosis stage. NBNC-HCC patients exhibited a higher proportion of Barcelona Clinic Liver Cancer (BCLC) classification stage C and stage D compared to patients from the HBV-HCC and HCV-HCC groups. With a mean of 2.33 ± 2.31 years of follow-up, the median survival of patients with NBNC-HCC was 1.75 (95% CI 1.33-2.17) years, which was significantly lower than that of patients with HBV-HCC (p = 0.041) and HCV-HCC (p < 0.001). CONCLUSIONS: Patients with NBNC-HCC have a higher risk of diabetes than patients with HCC of viral etiologies. Although patients with NBNC-HCC exhibited a milder fibrosis stage, their more advanced HCC stages and worse overall survival should be taken into consideration in clinical care.
BACKGROUND AND AIMS: The features of non-viral, nonalcohol hepatocellular carcinoma (NBNC-HCC) remain elusive. The aim of this study was to investigate this clinical characteristics and overall survival of NBNC-HCC compared to hepatitis B- (HBV-HCC) and hepatitis C-related (HCV-HCC) HCC. METHODS: We analyzed the etiologies, fibrosis stages, clinical data, and outcomes of newly diagnosed patients with HCC. RESULTS: A total of 1777 HCC patients were recruited, including 332 patients with NBNC-HCC, 682 patients with HBV-HCC, 680 patients with HCV-HCC, and 83 patients with HBV/HCV HCC. Patients with NBNC-HCC were older (69.9 ± 11.9 years). Patients with NBNC-HCC exhibited a higher prevalence of diabetes (43.9%) compared to the HBV-HCC (27.1%, p < 0.05) and HCV-HCC (30.2%, p < 0.05) groups. Compared to patients from the viral-related HCC groups, patients with NBNC-HCC exhibited a significantly lower fibrosis stage. NBNC-HCC patients exhibited a higher proportion of Barcelona Clinic Liver Cancer (BCLC) classification stage C and stage D compared to patients from the HBV-HCC and HCV-HCC groups. With a mean of 2.33 ± 2.31 years of follow-up, the median survival of patients with NBNC-HCC was 1.75 (95% CI 1.33-2.17) years, which was significantly lower than that of patients with HBV-HCC (p = 0.041) and HCV-HCC (p < 0.001). CONCLUSIONS:Patients with NBNC-HCC have a higher risk of diabetes than patients with HCC of viral etiologies. Although patients with NBNC-HCC exhibited a milder fibrosis stage, their more advanced HCC stages and worse overall survival should be taken into consideration in clinical care.