Outcomes after curative treatment for cryptogenic cirrhosis‐associated hepatocellular carcinoma satisfying the Milan criteria

AbstractBackground and Aim:  The prognosis of cryptogenic cirrhosis‐associated hepatocellular carcinoma (CC‐HCC) was reported to be poor because many of them were discovered at the advanced stage. The aim of this study is to reveal the clinical features of early CC‐HCC.Methods:  Consecutive 36 curatively treated CC‐HCC patients satisfying the Milan Criteria were compared with corresponding 211 HCV‐associated HCC (HCV‐HCC) patients. The clinical background, tumor recurrence rate, overall survival rate, and prognostic values of the patients were assessed.Results:  The size of CC‐HCCs was larger than that of HCV‐HCCs (P = 0.01). The respective tumor recurrence rates at 1, 3, and 5 years were 11%, 32%, and 46% in the CC‐HCC, and 21%, 59%, and 81% in the HCV‐HCC. The respective overall survival rates at 1, 3, and 5 years were 94%, 85%, and 80% in the CC‐HCC, and 98%, 81%, and 61% in the HCV‐HCC. CC‐HCC patients had a lower tumor recurrence rate and a higher survival rate compared to the HCV‐HCC patients (P = 0.001 and P = 0.02, respectively). Via multivariate analysis, significant factors for high recurrence rate were number of HCCs (P = 0.02) and serum alpha fetoprotein levels (P = 0.03) in CC‐HCC, whereas multiple tumors (P < 0.001), large tumor size (P = 0.01), and high alanine aminotransferase (P = 0.04) in HCV‐HCC. The factor for survival was albumin in both groups.Conclusion:  The size of CC‐HCC was larger than that of HCV‐HCC even in patients who received curative treatment; however, the risk for recurrence and the mortality of the patients with CC‐HCC was lower than those with HCV‐HCC.