Outcomes of hepatectomy for noncirrhotic hepatocellular carcinoma: A systematic review

• Compared with cirrhotic HCC, noncirrhotic HCC presents better preoperative liver function and more advanced tumor stage.
• Hepatectomy for noncirrhotic HCC carries low perioperative morbidity and mortality.
• Long-term outcomes after hepatectomy in the noncirrhotic group were significantly better than those in the cirrhotic group.

BackgroundNoncirrhotic hepatocellular carcinoma (HCC) is rare. The aim of this study was to evaluate the published evidence for hepatectomy in patients with noncirrhotic HCC.MethodsA literature search was conducted in PubMed database for eligible studies from the time of inception to March 2014. Comparisons of surgical outcomes for noncirrhotic and cirrhotic HCC were pooled and analyzed by meta-analytical techniques.ResultsThirty-one observational studies comprising a total of 3771 patients who underwent hepatectomy for noncirrhotic HCC were reviewed. The median postoperative morbidity was 29.5% (range, 8.3–55.5%) and mean mortality was 2.7% (range, 0–6.5%). Median 5-year overall and disease free survival was 47.9% (range, 26–81%) and 38.0% (range, 24.0–58.4%) respectively. In comparative studies, both the 5-year disease free (odds ratio (OR): 0.61, 95% confidence interval (95% CI): 0.51–0.72; P < 0.001) and overall survival (OR: 0.61, 95% CI: 0.42–0.90; P = 0.01) in the noncirrhotic group were significantly better than those in the cirrhotic group.ConclusionsHepatectomy for noncirrhotic HCC carries low perioperative morbidity and mortality and offers favorable long-term outcomes.