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Carvalho et al. Hepatoma Research 2018;4:15 Hepatoma Research
DOI: 10.20517/2394-5079.2018.13

Original Article Open Access

Hepatocellular carcinoma in patients without
cirrhosis: relevance and clinical characteristics

1
2
Kellyane Santana Dias Carvalho , Luciano E. Fonseca , Helma P. Cotrim 1
1 Medicine School, Universidade Federal da Bahia, Salvador 40110-060, Brazil.
2 University Hospital Prof. Edgar Santos, Universidade Federal da Bahia, Salvador 40110-060, Brazil.

Correspondence to: Dr. Helma P. Cotrim, Programa de Pós Graduação em Medicina e Saúde – PPgMS, Complexo Universitário Professor
Edgard Santos, Rua Augusto Viana, 50 Andar, Canela, Salvador 40110-060, Brazil. E-mail: helmacotrim@gmail.com
How to cite this article: Carvalho KSD, Fonseca LE, Cotrim HP. Hepatocellular carcinoma in patients without cirrhosis: relevance and
clinical characteristics. Hepatoma Res 2018;4:15. http://dx.doi.org/10.20517/2394-5079.2018.13
Received: 24 Feb 2018 First Decision: 21 Mar 2018 Revised: 8 May 2018 Accepted: 8 May 2018 Published: 29 May 2018

Science Editor: Guang-Wen Cao Copy Editor: Guang-Zhe Zhu Production Editor: Huan-Liang Wu

Abstract
Aim: The present study evaluated the frequency of hepatocellular carcinoma (HCC) in patients without cirrhosis.

Methods: HCC patients were recruited from two reference centers for liver disease in Northeast Brazil from 2010
to 2016. The diagnosis of HCC and cirrhosis was based on international criteria.

Results: A total of 169 patients were included, and 16% (27) of the patients did not have hepatocellular carcinoma
in non-cirrhosis (HCC-NC). The mean age of HCC-NC was 64.4 ± 11.3 years, and 74.1% of the patients were male.
The main risk factors were hepatitis C virus (HCV) in 29.6% (8), nonalcoholic steatohepatitis (NASH) in 14.8% (4)
and hepatitis B virus (HBV) in 11.1% (3). Histological HCC diagnosis was performed in 81.5% (22) of the patients,
and in 18.5% (5) of these patients, the diagnosis was performed by ultrasonography, computed tomography or
nuclear magnetic resonance imaging methods. Single nodules were found in 56% of HCC-NC (14) when assessed
by imaging methods.

Conclusion: The frequency of HCC-NC was elevated and more common in males. HCV, NASH and HBV were
the most frequent risk factors. These data contribute to discussion on future protocols and criteria for the early
diagnosis and treatment of HCC in patients with chronic liver disease without cirrhosis.

Keywords: Hepatocellular carcinoma, primary liver tumor, liver cirrhosis

INTRODUCTION
Hepatocellular carcinoma (HCC) is the most frequent primary malignant tumor found in the liver. HCC is

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