Prospective study of laparoscopic findings with regard to the development of hepatocellular carcinoma in patients with hepatitis C virus-associated cirrhosis

Background: The laparoscopic findings of hepatocarcinogenesis are not well defined. The purpose of this prospective study was to evaluate the predicti ve value of laparoscopic findings with regard to the development of hepatoc ellular carcinoma (HCC) in patients with hepatitis C virus (HCV)-associated cirrhosis. Methods: One hundred nineteen patients with HCV-associated cirrhosis who un derwent laparoscopy were enrolled in this study. Ten laparoscopic variables , including degree of development and size of regenerating nodules, irregul arity of regenerating nodules, and size of both hepatic lobes, were measure d. The predictive value of each finding for the development of HCC was inve stigated by using univariate and multivariate analyses. Results: HCC developed in a total of 42 of the 119 patients (35.3%) during a mean follow-up period of 62.9 months. The degree of regenerating nodules, the presence of irregular regenerative nodules, and atrophic right lobe we re significant predictive factors for HCC with univariate analysis. in part icular, 67.1% of patients with irregular regenerative nodules had HCC devel op within 5 years. Multivariate analysis revealed that irregular regenerati ve nodules (relative risk 6.32, p = 0.012), the degree of regenerative nodu les (relative risk 4.78, p = 0.029), and atrophic right lobe (relative risk 3,87, p = 0.048) were independent predictive factors. Conclusions: Morphologic observation of the liver surface by laparoscopy is important and provides information on factors that are statistically signi ficant early predictors of the development of HCC.