Correlation of clinicopathologic features of resected hepatocellular carcinoma with hepatitis C virus genotype

Clinicopathologic findings in patients with hepatocellular carcinoma compli cating hepatitis C virus and outcomes after liver resection were compared b etween different viral genotypes, One hundred and forty-seven patients with both anti-hepatitis C virus antibody and hepatitis C virus RNA in their se ra underwent curative resection for hepatocellular carcinoma in our departm ent between 1991 and 1997, Of these patients, 115 were infected with hepati tis C virus genotype 1b (group 1), and 32 were infected with 2a or 2b (grou p 2), Clinicopathologic findings and outcomes after operation were compared between the two groups. Alanine aminotransferase activity was significantl y higher in group 2 than in group 1, Genotypes did not differ concomitantly with histopathologic features of the carcinoma or adjacent hepatic tissue, Although the tumor-free survival rate did not differ significantly between the two groups, recurrence was not detected during the period beyond 3 yea rs following operation in group 2, while recurrences arose during that peri od in 16 group 1 patients, most of whom continued to manifest active hepati tis, In 7 of these 16 patients, the recurrent tumors were histologically mu lticentric in origin. The cumulative survival rate was significantly lower in group 1 than 2, Multivariate analysis indicated that genotype 1b was an independent risk factor for short survival. Patients infected with genotype 1b may have a relatively high risk of ongoing hepatocarcinogenesis and mor e aggressive progression of associated liver dysfunction, resulting in a po orer outcome than with other genotypes.