Tags

Type your tag names separated by a space and hit enter

Rate of incidence of hepatocellular carcinoma in patients with compensated viral cirrhosis.
Cancer. 1999 May 15; 85(10):2132-7.C

Abstract

BACKGROUND

Cirrhosis of viral etiology due to hepatitis B virus (HBV) or hepatitis C virus (HCV) infection is a risk factor for hepatocellular carcinoma (HCC). The current study evaluated the rate of incidence of HCC in patients with compensated cirrhosis of viral etiology.

METHODS

Two hundred fifty-nine cirrhotic patients (66 hepatitis B surface antigen [HBsAg] positive, 166 HCV positive, and 27 HBsAg/HCV positive) were longitudinally examined every 6 months by serum alpha-fetoprotein test and liver ultrasonography. The rates of incidence of HCC were calculated by the person-years method. The Kaplan-Meier method was used to estimate the cumulative probability of HCC development. Differences in survival time were evaluated by a log rank test. Independent predictors of HCC development were estimated by Cox proportional hazard regression analysis.

RESULTS

During a mean follow-up of 64.5 months, HCC developed in 51 (19.7%) patients: in 34 of 166 HCV positive subjects (20.5%) (mean follow-up, 66.3 months), in 6 of 66 of those HBsAg positive (9.1%) (mean follow-up, 55.06 months), and in 11 of 27 of those with dual HBsAg/HCV infection (40.7%) (mean follow-up, 76.4 months). The rate of incidence of HCC per 100 person-years of follow-up was 3.7 in HCV positive subjects, 2.0 in those HBsAg positive, and 6.4 in those with dual infection. Cumulative HCC appearance rates in HBsAg positive, HCV positive, and HBsAg/HCV positive subgroups were 10%, 21%, and 23% at 5 years, 16%, 28%, and 45% at 10 years, and 16%, 40%, and 55% at 13 years, respectively. Multivariate analysis indicated that age >50 years (hazard risk [HR], 4.5; 95% confidence interval [CI] = 2.1-9.4), male gender (HR, 2.8; 95% CI = 1.1-5.3), and HBsAg/HCV coinfection (HR, 2.3; 95% CI = 1.1-4.6) were independent predictors of HCC development.

CONCLUSIONS

These findings confirm that male gender and more advanced age (>50 years) are risk factors for HCC in patients with cirrhosis. Furthermore, the data indicate that subjects with dual HBsAg/HCV infection are at highest risk for HCC. Surveillance programs for early detection of HCC should focus especially on these patients.

Authors+Show Affiliations

Department of Gastroenterology, University of Padua, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10326690

Citation

Chiaramonte, M, et al. "Rate of Incidence of Hepatocellular Carcinoma in Patients With Compensated Viral Cirrhosis." Cancer, vol. 85, no. 10, 1999, pp. 2132-7.
Chiaramonte M, Stroffolini T, Vian A, et al. Rate of incidence of hepatocellular carcinoma in patients with compensated viral cirrhosis. Cancer. 1999;85(10):2132-7.
Chiaramonte, M., Stroffolini, T., Vian, A., Stazi, M. A., Floreani, A., Lorenzoni, U., Lobello, S., Farinati, F., & Naccarato, R. (1999). Rate of incidence of hepatocellular carcinoma in patients with compensated viral cirrhosis. Cancer, 85(10), 2132-7.
Chiaramonte M, et al. Rate of Incidence of Hepatocellular Carcinoma in Patients With Compensated Viral Cirrhosis. Cancer. 1999 May 15;85(10):2132-7. PubMed PMID: 10326690.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rate of incidence of hepatocellular carcinoma in patients with compensated viral cirrhosis. AU - Chiaramonte,M, AU - Stroffolini,T, AU - Vian,A, AU - Stazi,M A, AU - Floreani,A, AU - Lorenzoni,U, AU - Lobello,S, AU - Farinati,F, AU - Naccarato,R, PY - 1999/5/18/pubmed PY - 2000/6/20/medline PY - 1999/5/18/entrez SP - 2132 EP - 7 JF - Cancer JO - Cancer VL - 85 IS - 10 N2 - BACKGROUND: Cirrhosis of viral etiology due to hepatitis B virus (HBV) or hepatitis C virus (HCV) infection is a risk factor for hepatocellular carcinoma (HCC). The current study evaluated the rate of incidence of HCC in patients with compensated cirrhosis of viral etiology. METHODS: Two hundred fifty-nine cirrhotic patients (66 hepatitis B surface antigen [HBsAg] positive, 166 HCV positive, and 27 HBsAg/HCV positive) were longitudinally examined every 6 months by serum alpha-fetoprotein test and liver ultrasonography. The rates of incidence of HCC were calculated by the person-years method. The Kaplan-Meier method was used to estimate the cumulative probability of HCC development. Differences in survival time were evaluated by a log rank test. Independent predictors of HCC development were estimated by Cox proportional hazard regression analysis. RESULTS: During a mean follow-up of 64.5 months, HCC developed in 51 (19.7%) patients: in 34 of 166 HCV positive subjects (20.5%) (mean follow-up, 66.3 months), in 6 of 66 of those HBsAg positive (9.1%) (mean follow-up, 55.06 months), and in 11 of 27 of those with dual HBsAg/HCV infection (40.7%) (mean follow-up, 76.4 months). The rate of incidence of HCC per 100 person-years of follow-up was 3.7 in HCV positive subjects, 2.0 in those HBsAg positive, and 6.4 in those with dual infection. Cumulative HCC appearance rates in HBsAg positive, HCV positive, and HBsAg/HCV positive subgroups were 10%, 21%, and 23% at 5 years, 16%, 28%, and 45% at 10 years, and 16%, 40%, and 55% at 13 years, respectively. Multivariate analysis indicated that age >50 years (hazard risk [HR], 4.5; 95% confidence interval [CI] = 2.1-9.4), male gender (HR, 2.8; 95% CI = 1.1-5.3), and HBsAg/HCV coinfection (HR, 2.3; 95% CI = 1.1-4.6) were independent predictors of HCC development. CONCLUSIONS: These findings confirm that male gender and more advanced age (>50 years) are risk factors for HCC in patients with cirrhosis. Furthermore, the data indicate that subjects with dual HBsAg/HCV infection are at highest risk for HCC. Surveillance programs for early detection of HCC should focus especially on these patients. SN - 0008-543X UR - https://www.unboundmedicine.com/medline/citation/10326690/Rate_of_incidence_of_hepatocellular_carcinoma_in_patients_with_compensated_viral_cirrhosis_ L2 - https://medlineplus.gov/livercancer.html DB - PRIME DP - Unbound Medicine ER -