Strategy for hepatocellular carcinoma from the view point of viral status

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Serum markers for Hepatitis B and/or C virus were detected in about 97% of patients who underwent liver resection for hepatocellular carcinoma (HCC) in our department. In 1 % of the patients, hepatitic B virus gene was detected in HCC tissue. Hepatitis G virus RNA was detected in sera in 12 of 213 patients. The 12 patients also had serum markers for hepatitis B virus (HBV) or hepatitis C virus (HCV), indicating that the hepatitis G virus has poor association with HCC.The age was younger in patients infected with HBV than in patients infected with HCV.The tumor size was larger in patients infected with HBV than in patients infected with HCV.The amount of HBV sometimes increased after operation, followed by increase in alanine aminotransferase activity, in patients with wild-type HBV and large amount of HBV.In patients infected with HBV, the risk factors for recurrence included low platelet count, wild-type HBV, high viral load, positive surgical margin, and nonantomic resection. In patients infected with HCV, the risk factors included high age, positive serum HCV RNA, high activities of alanine and aspartate aminotransferase, larged tumor size (more than 4cm), multiple tumors, and portal invasion. Interferon therapy after resection of HCC may be useful to prevent recurrence. Extended resection (anatomic resection) is indicated for patients infected with HBV.For patients infected with HCV, not only complete resection of HCC but a1so strategy for HCV are necessary.