Characteristics and course of small hepatocellular carcinomas in patients with hepatitis C virus types 1 and 2

The associations between types of HCV and tumor characteristics and recurre nce and survival after treatment of small HCC were investigated. Viral geno type-specific antibodies were measured in sera obtained at the time of diag nosis of HCC, in 92 patients with HCC less than or equal to 2 cm in diamete r who were treated between 1990 and 1998. The degrees of tumor differentiat ion and angiographically-evaluated hypervascularity were compared between p atients infected with HCV type 1 and those with type 2. Survival, time to r ecurrence, and patterns of recurrence after initial treatment also were com pared. On pathologic evaluation, 6 of 21 HCC (28.6%) in patients with HCV t ype 2 were well-differentiated, whereas 28 of 48 HCC (58.3%) in patients wi th HCV type 1 were well-differentiated (P = 0.0229). HCC in patients with H CV type 2 showed hypervascularity more frequently than HCC in patients with HCV type 1, with tumor staining evident by digital subtraction arteriograp hy in 17 of 22 patients with HCV type 2 (77.3%) vs. 20 of 50 in patients wi th HCV type 1 (40.0%, P = 0.0036). Survival and overall recurrence rates we re similar in patients infected with HCV type 1 and with HCV type 2 (P = 0. 5537). In the analyses of patterns of recurrence, recurrences in patients i nfected with HCV type 2 were relatively more likely to be intrahepatic meta stases (P = 0.0342), that was closely related to the differentiation of HCC . Multicentric occurrence of HCC was more frequent type of recurrence in pa tients with HCV type 1 (P = 0.1619), and infection of HCV type 1 was an ind ependent factor for multicentric occurrence in multivariate analysis (P = 0 .0021). In HCC less than or equal to2 cm in diameter, HCV type 2 is associa ted with more progression of HCC than HCV type 1, whereas patients with HCV type 1 may be at higher risk for multicentric HCC occurrence after the tre atment of HCC. (C) 2001 Wiley-Liss, Inc.