Patients with non-viral liver disease have a greater tumor burden and less curative treatment options when diagnosed with hepatocellular carcinoma

Table 1 Etiology of liver disease n (%)

	HBV	HCV	Non-viral
No patients	467 (29)	299 (45)	268 (26)
Etiology of non-viral liver disease
Alcoholic liver disease			144 (53.7)
NAFLD			85 (31.7)
Haemochromatosis			18 (6.7)
Primary sclerosing cholangitis			6 (2.3)
Primary biliary cirrhosis			8 (3)
Alpha-1 antitrypsin deficiency			3 (1.1)
Congenital hepatic fibrosis			1 (0.4)
Autoimmune hepatitis			3 (1.1)

HBV: Hepatitis B virus; HCV: Hepatitis C virus; NAFLD: Non alcoholic fatty liver disease.

Table 2 Patient characteristics according to etiology of liver disease

	HBV	HCV	Non-viral	P value
Male (%)	84.3	79.2	80.6	< 0.250
Ethnicity (%)
Caucasian	16.4	73.4	87.3	< 0.001
Asian	75.8	18.2	9.0	< 0.001
Middle Eastern	3.7	7.1	2.2	< 0.001
Polynesian	2.3	0.6	0.0	< 0.001
Aboriginal	0.3	0.2	1.1	< 0.001
African	1.3	0.4	0.4	< 0.001
Median age (95%CI)	57 (55-59)	55 (54-56)	64 (63-65)	< 0.001
Screening program (%)	71	84	71	< 0.001
Median AFP (95%CI)	60 (40-98)	21 (16-28)	9 (6-19)	< 0.001

HBV: Hepatitis B virus; HCV: Hepatitis C virus; AFP: Alpha-fetoprotein.

Table 3 Severity of liver disease and cirrhosis at hepatocellular carcinoma diagnosis

	HBV (%)	HCV (%)	Non-viral (%)	P value
Child-Pugh score
A	58.6	53.9	41.9	< 0.001
B	13.7	29.0	28.3	< 0.001
C	4.9	14.4	17.1	< 0.001
Non-cirrhotic	22.8	2.6	12.8	< 0.001
Median MELD score	6.4	8.2	8.8	< 0.001
Cirrhosis	77.8	97.4	87.2	< 0.001

HCC: Hepatocellular carcinoma; HBV: Hepatitis B virus; HCV: Hepatitis C virus; MELD: Model for end stage liver disease.

Table 4 Tumor characteristics and vascular invasion

	HBV (%)	HCV (%)	Non-viral (%)	P value
Size of dominant lesion
< 1 cm	1.3	2.8	2.6	< 0.001
1-3 cm	34.4	46.5	32.1	< 0.001
3-5 cm	22.4	23.8	20.5	< 0.001
> 5 cm	32.0	18.0	34.0	< 0.001
Unknown	10.0	9.2	10.4	< 0.001
Tumor extent > 50%	12.4	4.2	12.5	< 0.001
Vascular invasion	10.4	6.7	12.3	< 0.020

HBV: Hepatitis B virus; HCV: Hepatitis C virus.

Table 5 Treatment modalities used for patients with hepatocellular carcinoma

Treatment	Hepatitis B (%)	Hepatitis C (%)	Non-viral (%)	P value
TACE	44.5	45.4	39.2	0.099
Ablation	11.1	18.4	10.8	0.011
Resection	24.4	8.8	13.1	< 0.001
Transplant	13.4	21.4	12.3	0.001
Sorafenib	5	4.1	4.1	0.098
Supportive care	21	20	29	< 0.02

HCC: Hepatocellular carcinoma; TACE: Trans arterial chemo embolisation.

Table 6 Multivariate analysis for predictors of survival

Variable	Reference	HR	95%CI for HR	P value
Hepatitis B	Non-viral	0.900	0.674-1.200	0.472
Hepatitis C	Non-viral	1.086	0.841-1.401	0.527
Age at presentation	Years	1.009	1.000-1.018	0.062
Non-cirrhotic	Child Pugh C	0.267	0.165-0.433	< 0.001
Child Pugh A	Child Pugh C	0.403	0.287-0.566	< 0.001
Child Pugh B	Child Pugh C	0.705	0.501-0.992	0.045
Gender	Male	0.978	0.748-1.280	0.874
MELD	MELD score	1.016	0.999-1.033	0.072
Resection	Yes	2.212	1.434-3.413	< 0.001
Dominant lesion < 1 cm	Dominant lesion > 5 cm	0.375	0.156-0.898	0.028
Dominant lesion 1-3 cm	Dominant lesion > 5 cm	0.527	0.394-0.704	< 0.001
Dominant lesion 3-5 cm	Dominant lesion > 5 cm	0.740	0.550-0.995	0.046
Sorafenib	Yes	1.118	0.688-1.817	0.652
TACE	Yes	1.371	0.938-2.004	0.103
Transplant	Yes	8.486	5.185-13.889	< 0.001
Tumor extent < 50%	Tumor extent > 50%	0.690	0.476-1.000	0.050
Vascular invasion	Yes	0.555	0.393-0.784	0.001

MELD: Model for end stage liver disease; TACE: Trans arterial chemo embolisation.