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Incidence and predictors of hepatocellular carcinoma in patients with cirrhosis.
Clin Gastroenterol Hepatol 2007; 5(8):938-45, 945.e1-4CG

Abstract

BACKGROUND & AIMS

Independent predictors of hepatocellular carcinoma in patients with cirrhosis are not well established.

METHODS

We created a cohort of 2126 patients (41% with hepatitis C virus [HCV] infection) who sought care from all Veterans Affairs health care centers in the northwest United States from 1994 to 2005 and who had a diagnosis of cirrhosis recorded in inpatient or outpatient medical records.

RESULTS

During a mean follow-up period of 3.6 years, 100 patients were diagnosed with hepatocellular carcinoma (incidence, 1.3 per 100 patient-years). Important predictors of hepatocellular carcinoma in multivariate models included HCV infection (adjusted hazard ratio [ahr], 3.0; 95% confidence interval [CI], 1.7-5.3); hepatitis B virus (HBV) surface antigen (ahr, 3.3; 95% CI, 1.4-7.7); HBV core antibody (ahr, 1.7; 95% CI, 1.1-2.8); obesity (ahr, 2.5; 95% CI, 1.3-4.9), and overweight (ahr, 2.8; 95% CI, 1.5-5.4) relative to patients with a body mass index of < 25 kg/m2, diabetes (ahr, 1.5; 95% CI, 0.9-2.5), and low platelet count (relative to patients with a platelet count of > 266 thousands/microL, the ahr was 2.1 [95% CI, 0.8-5.6] in patients with a platelet count of 180-266 thousands/microL, 3.3 [95% CI, 1.3-8.0] in patients with a platelet count of 111-179 thousands/microL, and the ahr was 4.7 [95% CI, 2.0-11.4] in patients with a platelet count of < or = 110 thousands/microL).

CONCLUSIONS

We identified 6 important predictors of hepatocellular carcinoma in multivariate models (including relatively novel predictors such as increased body mass index, HBV core antibody, and low platelet count), which suggest a means of predicting the risk of hepatocellular carcinoma in patients with cirrhosis and optimizing surveillance strategies.

Authors+Show Affiliations

Division of Gastroenterology, Department of Medicine, Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, Washington 98108, USA. georgei@medicine.washington.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

17509946

Citation

Ioannou, George N., et al. "Incidence and Predictors of Hepatocellular Carcinoma in Patients With Cirrhosis." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 5, no. 8, 2007, pp. 938-45, 945.e1-4.
Ioannou GN, Splan MF, Weiss NS, et al. Incidence and predictors of hepatocellular carcinoma in patients with cirrhosis. Clin Gastroenterol Hepatol. 2007;5(8):938-45, 945.e1-4.
Ioannou, G. N., Splan, M. F., Weiss, N. S., McDonald, G. B., Beretta, L., & Lee, S. P. (2007). Incidence and predictors of hepatocellular carcinoma in patients with cirrhosis. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 5(8), pp. 938-45, 945.e1-4.
Ioannou GN, et al. Incidence and Predictors of Hepatocellular Carcinoma in Patients With Cirrhosis. Clin Gastroenterol Hepatol. 2007;5(8):938-45, 945.e1-4. PubMed PMID: 17509946.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence and predictors of hepatocellular carcinoma in patients with cirrhosis. AU - Ioannou,George N, AU - Splan,Meaghan F, AU - Weiss,Noel S, AU - McDonald,George B, AU - Beretta,Laura, AU - Lee,Sum P, Y1 - 2007/05/16/ PY - 2007/5/19/pubmed PY - 2007/12/6/medline PY - 2007/5/19/entrez SP - 938-45, 945.e1-4 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 5 IS - 8 N2 - BACKGROUND & AIMS: Independent predictors of hepatocellular carcinoma in patients with cirrhosis are not well established. METHODS: We created a cohort of 2126 patients (41% with hepatitis C virus [HCV] infection) who sought care from all Veterans Affairs health care centers in the northwest United States from 1994 to 2005 and who had a diagnosis of cirrhosis recorded in inpatient or outpatient medical records. RESULTS: During a mean follow-up period of 3.6 years, 100 patients were diagnosed with hepatocellular carcinoma (incidence, 1.3 per 100 patient-years). Important predictors of hepatocellular carcinoma in multivariate models included HCV infection (adjusted hazard ratio [ahr], 3.0; 95% confidence interval [CI], 1.7-5.3); hepatitis B virus (HBV) surface antigen (ahr, 3.3; 95% CI, 1.4-7.7); HBV core antibody (ahr, 1.7; 95% CI, 1.1-2.8); obesity (ahr, 2.5; 95% CI, 1.3-4.9), and overweight (ahr, 2.8; 95% CI, 1.5-5.4) relative to patients with a body mass index of < 25 kg/m2, diabetes (ahr, 1.5; 95% CI, 0.9-2.5), and low platelet count (relative to patients with a platelet count of > 266 thousands/microL, the ahr was 2.1 [95% CI, 0.8-5.6] in patients with a platelet count of 180-266 thousands/microL, 3.3 [95% CI, 1.3-8.0] in patients with a platelet count of 111-179 thousands/microL, and the ahr was 4.7 [95% CI, 2.0-11.4] in patients with a platelet count of < or = 110 thousands/microL). CONCLUSIONS: We identified 6 important predictors of hepatocellular carcinoma in multivariate models (including relatively novel predictors such as increased body mass index, HBV core antibody, and low platelet count), which suggest a means of predicting the risk of hepatocellular carcinoma in patients with cirrhosis and optimizing surveillance strategies. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/17509946/Incidence_and_predictors_of_hepatocellular_carcinoma_in_patients_with_cirrhosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(07)00231-5 DB - PRIME DP - Unbound Medicine ER -