Primary liver cancers carry significant morbidity and mortality. Hepatocellular carcinoma (HCC) develops within the hepatic parenchyma and is the most common malignancy originating from the liver. Although 80% of HCCs develop within background cirrhosis, 20% may arise in a non-cirrhotic milieu and are referred to non-cirrhotic-HCC (NCHCC). NCHCC is often diagnosed late due to lack of surveillance. In addition, the rising prevalence of non-alcoholic fatty liver disease and diabetes mellitus have increased the risk of developing HCC on non-cirrhotic patients. Viral infections such as chronic Hepatitis B and less often chronic hepatitis C with advance fibrosis are associated with NCHCC. NCHCC individuals may have Hepatitis B core antibodies and occult HBV infection, signifying the role of Hepatitis B infection in NCHCC. Given the effectiveness of current antiviral therapies, surgical techniques and locoregional treatment options, nowadays such patients have more options and potential for cure. However, these lesions need early identification with diagnostic models and multiple surveillance strategies to improve overall outcomes. Better understanding of the NCHCC risk factors, tumorigenesis, diagnostic tools and treatment options are critical to improving prognosis and overall outcomes on these patients. In this review, we aim to discuss NCHCC epidemiology, risk factors, and pathogenesis, and elaborate on NCHCC diagnosis and treatment strategies.

Non-cirrhotic hepatocellular carcinoma in chronic viral hepatitis: Current insights and advancements.

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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/cld.1196

Hepatocellular Carcinoma in Mexico

Introduction and aim Hepatocellular carcinoma (HCC) is the most frequent primary tumor of the liver. HCC in the noncirrhotic liver accounts for 15-20% of all HCC. Noncirrhotic HCC is a clinically different entity because of the non-neoplastic liver parenchyma involved. Our aim was to describe the presentation, treatment, and predictive survival results of noncirrhotic HCC in Veracruz. Materials and methods A retrospective study, spanning 13 years, was conducted on patients with noncirrhotic HCC. It analyzed their clinical characteristics, fibrosis/cirrhosis biologic index (NAFLD, MELD, ALBI, APRI, CDS, FIB-4, GUCI, LOK) results, disease treatment, and survival. Results From a total of 168 cases of HCC, 33 (19.6%) noncirrhotic patients were included in the study. Of those patients, the mean patient age was 67.3 years (51.5% men), 9.1% had hepatitis C virus infection, and 27.3% were alcoholics. Less than 20% of the patients had biologic indexes suggestive of fibrosis/cirrhosis. Mean tumor size was 7.7 cm and 42.4% of the patients had alpha-fetoprotein (AFP) levels > 15 ng/mL. A total of 52.5% of the tumors were classified as Okuda II and 30.3% of the patients had advanced disease (the Milan criteria). Liver resection was performed on 51.5% of the patients, radiofrequency ablation on 18.2%, and transarterial chemoembolization on 9.1%. The overall 5-year survival rate was 55.4%. Liver resection resulted in the best 5-year survival rate (72.7%). Age > 67 years and elevated AFP levels were associated with poorer survival (p  Conclusions The characteristics and survival rate of HCC in the noncirrhotic liver were similar to those reported in other studies. Liver resection provided the highest survival rates. The liver fibrosis biologic indexes were not risk factors for survival.

Hepatocellular carcinoma in the noncirrhotic liver: Clinical features and outcomes in Veracruz, Mexico

Resumen Introduccion y objetivo El carcinoma hepatocelular (CHC) es el tumor primario mas frecuente del higado. La incidencia de CHC en higado no cirrotico es del 15-20% de todos los CHC. El parenquima hepatico no tumoral hace que el CHC no cirrotico sea una entidad clinica diferente. El objetivo fue describir la presentacion, el tratamiento y los resultados predictivos de sobrevida de CHC en higado no cirrotico en nuestra poblacion. Material y metodos Estudio retrospectivo de 13 anos en pacientes con CHC no cirrotico, analizando caracteristicas clinicas e indices biologicos de fibrosis/cirrosis (NAFLD, MELD, ALBI, APRI, CDS, FIB-4, GUCI, Lok), tratamiento y sobrevida. Resultados Se incluyeron 33 pacientes con CHC en higado no cirrotico de 168 CHC (19.6%); edad promedio 67.3 anos (51.5% hombres), 9.1% con virus de la hepatitis C y 27.3% con abuso de alcohol. El 20% tenia indices biologicos probables de fibrosis/cirrosis; el tamano promedio tumoral fue 7.7 cm y el 42.4% tenian alfafetoproteina > 15 ng/ml. Se clasificaron 52.5% Okuda II y 30.3% enfermedad avanzada (criterios de Milan). Se trataron 51.5% con reseccion hepatica, 18,2% ablacion por radiofrecuencia y 9,1% quimioembolizacion transarterial. La sobrevida global a 5 anos fue de 55,4%. La reseccion hepatica tuvo la mejor supervivencia a 5 anos (72.7%). La edad > 67 anos y el aumento de alfafetoproteina se asocio con una menor sobrevida (p  Conclusiones El CHC en higado no cirrotico tiene unas caracteristicas y sobrevida similar a otros sitios. La reseccion hepatica tiene la mayor sobrevida. Los indices biologicos de fibrosis no fueron factores de riesgo para la sobrevida.

Carcinoma hepatocelular en hígado no cirrótico: características clínicas y resultados en Veracruz, México

https://www.medigraphic.com/pdfs/cirgen/cg-2022/cg224e.pdf

Carcinoma hepatocelular en una paciente joven sobre hígado no cirrótico

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Hepatocellular carcinoma in the noncirrhotic liver: Clinical features and outcomes in Veracruz, Mexico

Carcinoma hepatocelular en hígado no cirrótico: características clínicas y resultados en Veracruz, México

Carcinoma hepatocelular en una paciente joven sobre hígado no cirrótico