Non-Cirrhotic Vs Cirrhotic Hcc: Comparison Between Patient Characteristics, Aetiology And Outcomes

Introduction Hepatocellular carcinoma (HCC) causes more than 5,400 deaths per year in the UK and is rising in incidence. Previously in the UK, HCC in non-cirrhotic livers was felt to be uncommon. We sought to establish the proportion of HCC occurring in patients without cirrhosis in our region of the UK and compare characteristics of those with cirrhosis. Methods Data was collected from our prospectively collected database on patient demographics, liver aetiology, stage at presentation and outcome for patients diagnosed with HCC at our regional MDT from 2009 to 2015. Results A total of 638 patients with HCC were included. 140 (21.9%) had no underlying cirrhosis. Non-cirrhotic HCCs were older at diagnosis (72 years vs 68 years, p = 0.001), with a similar male to female ratio. Alcohol related liver disease (ArLD) was the most common underlying aetiology in patients with cirrhosis (59%; see table 1), and along with Viral hepatitis was significantly more common than patients without cirrhosis. In contrast, unknown aetiology represented the majority of diagnoses, and was significantly greater in the non-cirrhotic cohort. Patients with non-cirrhotic HCC had more advanced malignant disease at diagnosis compared to cirrhotic HCC using Barcelona Clinic Liver Cancer (BCLC) staging, p Conclusion In our study nearly 22% of HCCs occurred in patients without underlying cirrhosis. A high proportion of non-cirrhotic HCC patients had unknown aetiology of liver disease. Patients with non-cirrhotic HCC were diagnosed at an older age with more advanced disease but lower mortality compared to patients with cirrhotic HCC.