Multicentric occurrence of hepatocellular carcinoma with nonalcoholic steatohepatitis

Table 1 Clinical characteristics of patients with nonalcoholic steatohepatitis-related hepatocellular carcinoma with or without multicentric occurrence

	HCC with MO				HCC without MO
Case	1	2	3	4	5	6	7	8	9	10	11	12
Age at Dx of NASH	73	81	78	71	68	75	71	80	75	78	81	66
Gender	F	M	M	F	M	F	M	F	F	M	M	M
History of BTF	-	-	-	-	-	-	-	+	-	-	-	-
BMI (kg/m2)	31.0	26.3	25.5	32.0	26.8	23.0	27.0	32.1	34.0	23.1	24.5	25.2
T2DM	+	+	+	+	-	+	+	-	+	-	-	-
Hypertension	+	+	+	+	-	-	-	+	+	-	+	+
Dyslipidemia	-	-	-	+	-	+	+	+	-	+	+	-
Varices	-	-	-	-	+	-	+	-	+	-	-	-
Ascites	-	-	-	-	-	-	-	-	-	-	-	-
AST (IU/L)	91	67	43	33	34	43	36	34	43	25	83	78
ALT (IU/L)	46	48	49	21	17	32	22	33	40	20	37	75
γ-GTP (IU/L)	122	129	418	72	30	222	46	67	73	104	360	279
Total bilirubin (mg/dL)	1.0	0.7	0.8	1.1	1.4	1.1	1.5	0.6	1.2	0.6	0.6	0.8
Albumin (g/dL)	3.8	3.7	3.4	2.9	3.3	4.0	2.9	4.1	3.7	3.8	3.4	4.2
Prothrombin time (%)	53	72	97	62	69	NAa	59	69	86	75	84	NAa
Platelet (× 104/μL)	21.1	12.3	10.4	11.2	4.5	14.5	6.4	31.6	11.7	12.1	26.4	11.4
Child-Pugh score	A	A	A	B	B	-a	B	A	A	A	A	-a
HBsAg	-	-	-	-	-	-	-	-	-	-	-	-
Anti-HBc	+	-	-	+	-	-	-	-	+	+	-	+
Anti-HCV	-	-	-	-	-	-	-	-	-	-	-	-
Histological features (Classification by Brunt)
Grade	2	2	2	2	1	2	2	1	1	1	2	2
Stage	4	4	4	4	4	4	4	4	4	1	2	4
Type of cirrhosis	Mixed	Mixed	Macro	Mixed	Micro	Mixed	Mixed	Mixed	Mixed	-	-	Macro
AFP (ng/mL)	11	26	15	25	7	9	3	8 757	12	2 963	900 100	8
DCP (mAU/mL)	18	24	20	116	24	NAa	14	35	907	131	10 700	NAa
Maximum size of HCC (mm)	35	50	40	28	22	17	50	26	40	40	110	70
Number of HCC	Mul	Mul	Mul	Mul	Mul	Sol	Mul	Sol	Mul	Mul	Mul	Sol
TNM stage	III	III	III	III	IVA	I	III	II	III	IVB	III	II
Initial treatment	Ope	TACE	Ope	TACE	TAI	RFA	TACE	TACE	Ope	Chemo	Ope	TAI
		+ RFA		+ RFA				+ Ope	+ RFA			+ Ope
Outcome	Alive	Dead	Dead	Alive	Alive	Alive	Alive	Alive	Dead	Dead	Alive	Alive
Cause of death	-	LR	NLR	-	-	-	-	-	LR	LR	-	-
Follow-up period after Dx of HCC (days)	2 599	1 706	288	1 140	280	1 011	687	2 198	1 525	489	162	330

HCC: hepatocellular carcinoma; MO: multicentric occurrence; Dx: diagnosis; BTF: blood transfusion; BMI: body mass index; M: Male; F: Female; T2DM: type 2 diabetes mellitus; AST: aspartate aminotransferase; ALT: alanine aminotransferase; γ-GTP: γ-glutamyltranspeptidase; NA: not available; AFP: alpha-fetoprotein; DCP: des-γ-carboxy-prothrombin; Mixed: mixed nodular cirrhosis; Macro: macronodular cirrhosis; Micro: micronodular cirrhosis; Mul: multiple; Sol: solitary; TACE: transcatheter arterial chemoembolization; TAI: transcatheter arterial infusion chemotherapy; RFA: radiofrequency ablation; Ope: operation; LR: liver-related death; NLR: non-liver-related death;

^aAn oral administration of warfarin prevented the evaluation.

Table 2 Clinical characteristics of patients with nonalcoholic steatohepatitis-related hepatocellular carcinoma with multicentric occurrence in previous and present reports

Author	Cases	Age older than 70 yr	Gender		Metabolic diseases				Histological features
			M	F	OB	DM	DL	HT	LC	Non-LC
Zen et al[6]	1	1	0	1	0	1	0	0	1	0
Sasaki et al[7]	1	1	0	1	1	1	0	0	1	0
Present authors	4	4	2	2	4	4	1	4	4	0
Total	6	6	2	4	5	6	1	4	6	0
(%)	-	(100)	(33.3)	(66.7)	(83.3)	(100)	(16.7)	(66.7)	(100)	(0)

M: male; F: female; OB: obesity; DM: type 2 diabetes mellitus; DL: dyslipidemia; HT: hypertension; LC: liver cirrhosis; Non-LC: non-liver cirrhosis. All values represent number of cases.

Table 3 Clinical characteristics of patients with solitary hepatocellular carcinoma related to nonalcoholic steatohepatitis in previous and present reports

Author	Cases	Age older than 70 yr	Gender		Metabolic diseases				Histological features
			M	F	OB	DM	DL	HT	LC	Non-LC
Cotrim et al[21]	1	0	1	0	1	1	0	0	1	0
Orikasa et al[22]	1	0	0	1	0	1	0	0	1	0
Shimada et al[23]	4	1	2	2	3	2	1	2	4	0
Mori et al[24]	1	1	1	0	1	1	0	0	1	0
Bullock et al[25]	2	1	2	0	2	2	0	2	0	2
Cuadrado et al[26]	2	1	2	0	2	2	0	0	1	1
Sato et al[27]	1	0	1	0	1	0	1	0	0	1
Ichikawa et al[28]	2	0	1	1	1	0	1	1	0	2
Ikeda et al[29]	1	0	1	0	1	1	0	1	1	0
Hai et al[30]	2	1	2	0	2	2	0	1	1	1
Hashizume et al[31]	7	5	4	3	5	5	6	5	5	2
Maeda et al[32]	3	0	2	1	NA	NA	NA	NA	3	0
Kawada et al[33]	6	4	3	3	2	3	1	4	0	6
Malik et al[34]	8	2	6	2	5	6	NA	5	8	0
Chagas et al[35]	4	3	2	2	4	3	1	NA	4	0
Takuma et al[36]	8	5	4	4	4	6	3	6	3	5
Present authors	3	2	1	2	2	1	2	2	3	0
Total	56	26	35	21	36	36	16	29	36	20
(%)	-	(46.4)	(62.5)	(37.5)	(67.9)	(67.9)	(35.6)	(59.2)	(64.3)	(35.7)

M: male; F: female; OB: obesity; DM: type 2 diabetes mellitus; DL: dyslipidemia; HT: hypertension; NA: not available; LC: liver cirrhosis; Non-LC: non-liver cirrhosis. All values represent number of cases.