Hepatocellular carcinoma in non-cirrhotic liver: a reappraisal

Dig Liver Dis. 2010 May;42(5):341-7. doi: 10.1016/j.dld.2009.09.002. Epub 2009 Oct 13.


Although not frequently, hepatocellular carcinoma (HCC) can ensue in a non-cirrhotic liver. As compared to cirrhotic HCC, this kind of tumour has some peculiarities, such as: (a) a lower male preponderance and a bimodal age distribution; (b) a lower prevalence of the three main risk factors (hepatitis B and C virus infections and alcohol abuse), with an increased prevalence of other etiologic factors, such as exposure to genotoxic substances and sex hormones, inherited diseases, genetic mutations; (c) a more advanced tumour stage at the time of diagnosis, as it is usually detected due to the occurrence of cancer-related symptoms, outside any scheduled surveillance program; (d) a much higher amenability to hepatic resection, due to the low risk of liver failure even after extended parenchymal mutilation; (e) overall and disease-free survivals after resection of non-advanced tumours (meeting the Milano criteria) comparable to that obtained with liver transplantation in cirrhotic patients carrying an early tumour; (f) overall survival strictly dependent on tumour burden (and its recurrence) and barely influenced by liver function.

Publication types

  • Review

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Alcoholism / complications
  • Carcinoma, Hepatocellular / complications
  • Carcinoma, Hepatocellular / surgery
  • Carcinoma, Hepatocellular / virology*
  • Disease-Free Survival
  • Female
  • Hepatectomy
  • Hepatitis, Viral, Human / complications*
  • Humans
  • Liver Neoplasms / complications
  • Liver Neoplasms / surgery
  • Liver Neoplasms / virology*
  • Male
  • Middle Aged
  • Prejudice
  • Young Adult