Tomi W Jun1, Ming-Lun Yeh2, Ju Dong Yang3, Vincent L Chen1,4, Pauline Nguyen1, Nasra H Giama3, Chung-Feng Huang2, Ann W Hsing5, Chia-Yen Dai2, Jee-Fu Huang2, Wan-Long Chuang2, Lewis R Roberts3, Ming-Lung Yu2, Mindie H Nguyen1. 1. Division of Gastroenterology and Hepatology, Stanford University Medical Center, Stanford, CA, USA. 2. Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. 3. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA. 4. Division of Gastroenterology, University of Michigan Health System, Ann Arbor, MI, USA. 5. Stanford Prevention Research Center, Stanford Cancer Institute, Stanford, CA, USA.
Abstract
BACKGROUND & AIMS: Although hepatitis B virus (HBV) and hepatitis C virus (HCV) infections remain major risk factors for hepatocellular carcinoma (HCC), non-viral causes of HCC, particularly non-alcoholic fatty liver disease (NAFLD), are becoming increasingly prevalent. The aim of this study was to compare the clinical characteristics and survival of cryptogenic and viral HCC. METHODS: We conducted a retrospective cohort study involving 3878 consecutive HCC patients seen at two tertiary centres in the United States and one in Taiwan from 2004 to 2014. We compared the clinical characteristics, treatment and survival of patients by underlying aetiology: cryptogenic (n = 696), HBV (n = 1304) or HCV (n = 1878). RESULTS: Cirrhosis was present in 66.8% of the cryptogenic HCC patients, compared with 74.7% of HBV-related HCC (HBV-HCC) (P = .001) and 85.9% of HCV-HCC (P < .001). Compared to viral HCC, cryptogenic HCC patients presented with larger tumours and at later stages of disease. Five-year overall survival was 16.3% among cryptogenic HCC patients compared with 31.9% among HBV-HCC patients and 27.7% among HCV-HCC patients (P < .001 for both by the log-rank test). HCC aetiology was not an independent predictor of survival, though ethnicity, cirrhosis status, meeting Milan criteria and treatment allocation were. CONCLUSIONS: Compared with viral HCC patients, those with cryptogenic HCC had lower prevalence of cirrhosis, were diagnosed with larger tumours at more advanced stages of disease, and had poorer overall survival. Additional efforts are needed to identify patients at risk of cryptogenic HCC and to identify cryptogenic HCC at earlier stages of disease.
BACKGROUND & AIMS: Although hepatitis B virus (HBV) and hepatitis C virus (HCV) infections remain major risk factors for hepatocellular carcinoma (HCC), non-viral causes of HCC, particularly non-alcoholic fatty liver disease (NAFLD), are becoming increasingly prevalent. The aim of this study was to compare the clinical characteristics and survival of cryptogenic and viral HCC. METHODS: We conducted a retrospective cohort study involving 3878 consecutive HCC patients seen at two tertiary centres in the United States and one in Taiwan from 2004 to 2014. We compared the clinical characteristics, treatment and survival of patients by underlying aetiology: cryptogenic (n = 696), HBV (n = 1304) or HCV (n = 1878). RESULTS:Cirrhosis was present in 66.8% of the cryptogenic HCC patients, compared with 74.7% of HBV-related HCC (HBV-HCC) (P = .001) and 85.9% of HCV-HCC (P < .001). Compared to viral HCC, cryptogenic HCC patients presented with larger tumours and at later stages of disease. Five-year overall survival was 16.3% among cryptogenic HCC patients compared with 31.9% among HBV-HCC patients and 27.7% among HCV-HCC patients (P < .001 for both by the log-rank test). HCC aetiology was not an independent predictor of survival, though ethnicity, cirrhosis status, meeting Milan criteria and treatment allocation were. CONCLUSIONS: Compared with viral HCC patients, those with cryptogenic HCC had lower prevalence of cirrhosis, were diagnosed with larger tumours at more advanced stages of disease, and had poorer overall survival. Additional efforts are needed to identify patients at risk of cryptogenic HCC and to identify cryptogenic HCC at earlier stages of disease.
Authors: Alexander L Nguyen; Haesuk Park; Pauline Nguyen; Edward Sheen; Yoona A Kim; Mindie H Nguyen Journal: Dig Dis Sci Date: 2018-10-16 Impact factor: 3.199
Authors: Clemens Schotten; Lars P Bechmann; Paul Manka; Jens Theysohn; Alexander Dechêne; Amr El Fouly; Francesco Barbato; Ursula Neumann; Sonia Radünz; Svenja Sydor; Dominik Heider; Marino Venerito; Ali Canbay; Guido Gerken; Ken Herrmann; Heiner Wedemeyer; Jan Best Journal: Liver Cancer Date: 2019-07-29 Impact factor: 11.740