Document Detail


Annual Incidence of Hepatocellular Carcinoma Among Patients with Alcoholic Cirrhosis and Identification of Risk Groups.
MedLine Citation:
PMID:  22982095     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND & AIMS: The incidence of hepatocellular carcinoma (HCC) and associated risk factors in patients with alcoholic cirrhosis are not well defined. Surveillance for HCC among patients with cirrhosis who do not have Hepatitis B is cost effective only if the expected risk of HCC exceeds 1.5% per year. We performed a prospective study to determine the incidence of HCC among patients with alcoholic cirrhosis and identify risk factors. METHODS: We analyzed data from a surveillance program of 450 patients, 40-75 years old, with alcoholic liver cirrhosis of Child-Pugh class A or B; patients were enrolled at the liver unit of a tertiary center from September 1992 through March 2010. Data were collected on 20 demographic, clinical, and laboratory variables at the start of the study. Patients were examined every 3-6 months for 5 years to identify risk factors for HCC; incidence was determined from a median follow-up time of 42 months. RESULTS: Over the follow-up period, 62 patients developed HCC (43 in the first 5 years of follow up), with an annual incidence of 2.6%. Using multivariate analysis, age ≥55 y (hazard ratio [HR], 2.39; 95% confidence interval [CI], 1.27-4.51) and platelet counts <125×10(3)/mm(3) (HR, 3.29; 95% CI, 1.39-7.85) were independently associated with the development of HCC. These variables were used to define 3 risk groups. The annual incidence of HCC in the group without either of these factors was 0.3% (n=93), with 1 factor was 2.6% (n=228), and with both was 4.8% (n=129) (P<.0001). CONCLUSIONS: The annual incidence of HCC among patients with alcoholic cirrhosis of Child-Pugh class A or B is around 2.5%. Age and platelet count can be used to classify the patients in 3 different risk groups for HCC development within the next 5 years.
Authors:
Alejo Mancebo; M Luisa González-Diéguez; Valle Cadahía; María Varela; Ramón Pérez; Carmen A Navascués; Nieves G Sotorríos; Maribel Martínez; Luis Rodrigo; Manuel Rodríguez
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-12
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  -     ISSN:  1542-7714     ISO Abbreviation:  Clin. Gastroenterol. Hepatol.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.
Affiliation:
Liver Unit. Hospital Universitario Central de Asturias. Oviedo. Spain; Department of Gastroenterology and Hepatology, Hospital Universitario Central de Asturias. Oviedo. Spain.
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