Journal of Gastrointestinal Cancer

, Volume 50, Issue 4, pp 808–815 | Cite as

Outcomes Following Resection of Hepatocellular Carcinoma in the Absence of Cirrhosis

  • Richard H. Lewis
  • Evan S. Glazer
  • David M. Bittenbinder
  • Thomas O’Brien
  • Jeremiah L. Deneve
  • David Shibata
  • Stephen W. Behrman
  • Jason M. Vanatta
  • Sanjaya K. Satapathy
  • Paxton V. DicksonEmail author
Original Research



Hepatocellular carcinoma (HCC) occasionally occurs in non-cirrhotic patients; however, outcomes for these patients are not extensively documented.


We performed an institutional review of patients without cirrhosis who underwent resection for HCC. Clinical data were evaluated to identify factors impacting recurrence-free survival (RFS) and overall survival (OS).


Forty-two patients underwent hepatectomy for HCC in the absence of cirrhosis over a 10-year period. Median follow-up was 22 months. For the entire cohort, 1-, 3-, and 5-year RFS was 62%, 42%, and 38% and 1-, 3-, and 5-year OS was 78%, 60%, and 49%, respectively. On univariate analysis, RFS was significantly worse for patients with a disrupted/absent tumor capsule (p = 0.027), vascular invasion (p = 0.030), elevated alkaline phosphatase (p = 0.004), and tumor size > 10 cm (p = 0.016). OS was significantly worse for patients with a disrupted/absent tumor capsule (p = 0.044), obesity (p = 0.036), and elevated alkaline phosphatase (p = 0.007) with a trend towards decreased OS for tumor size > 10 cm (p = 0.07).


Patients undergoing resection for HCC in the absence of cirrhosis have fairly high recurrence and modest survival rates. Pre-operative alkaline phosphatase, tumor size, tumor encapsulation, and vascular invasion are important prognostic factors.


Hepatocellular carcinoma Non-cirrhotic Surgery 


Compliance with Ethical Standards

This study did not receive any funding. No author has any financial conflict of interest. This article represents a retrospective review of an institutional experience and does not contain any studies with human participants performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Richard H. Lewis
    • 1
  • Evan S. Glazer
    • 1
    • 2
  • David M. Bittenbinder
    • 1
  • Thomas O’Brien
    • 3
  • Jeremiah L. Deneve
    • 1
    • 2
  • David Shibata
    • 1
    • 2
  • Stephen W. Behrman
    • 1
  • Jason M. Vanatta
    • 4
  • Sanjaya K. Satapathy
    • 5
  • Paxton V. Dickson
    • 1
    • 2
    Email author
  1. 1.Department of Surgery, Division of Surgical OncologyUniversity of Tennessee Health Science CenterMemphisUSA
  2. 2.West Cancer CenterMemphisUSA
  3. 3.Memphis Pathology GroupMemphisUSA
  4. 4.Transplant CenterCleveland Clinic Florida-WestonWestonUSA
  5. 5.Methodist University Transplant InstituteMemphisUSA

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