Federico Piñero1, Paulo Costa2, Yuri Longatto Boteon3, Sergio Hoyos Duque4, Sebastian Marciano5, Margarita Anders6, Adriana Varón7, Alina Zerega8, Jaime Poniachik9, Alejandro Soza10, Martín Padilla Machaca11, Josemaría Menéndez12, Rodrigo Zapata13, Mario Vilatoba14, Linda Muñoz15, Martín Maraschio16, Luis G Podestá17, Lucas McCormack6, Adrian Gadano5, Ilka S F Fatima Boin3, Parente García2, Marcelo Silva17. 1. Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Austral University, School of Medicine, avenue Presidente-Perón 1500, (B1629HJ) Pilar, Buenos Aires, Argentina. Electronic address: fpinerof@cas.austral.edu.ar. 2. Hospital Federal University of Ceará, Ceara, Brazil. 3. Hospital de Clinicas, State University of Campinas, Campiñas, Brazil. 4. Hospital Pablo Tobón Uribe and Gastroenterology group from Universidad de Antioquía, Medellín, Colombia. 5. Hospital Italiano from Buenos Aires, Buenos Aires, Argentina. 6. Hospital Alemán, Buenos Aires, Argentina. 7. Fundación Cardioinfantil, Instituto de Cardiología, Bogotá, Colombia. 8. Sanatorio Allende from Córdoba, Córdoba, Argentina. 9. Hospital Clínico Universidad de Chile, Santiago de Chile, Chile. 10. Hospital Universidad Católica de Chile, Santiago de Chile, Chile. 11. Hospital Guillermo Almenara, Lima, Peru. 12. Hospital Militar-Clínicas, Montevideo, Uruguay. 13. Clinica Alemana de Santiago, Universidad del Desarrollo, Santiago de Chile, Chile; Hospital del Salvador, Universidad de Chile, Santiago de Chile, Chile. 14. Instituto de Ciencias Médicas, Ciudad de Mexico, Mexico. 15. Hospital Universitario de Monterrey, Monterrey, Mexico. 16. Hospital Privado from Córdoba, Córdoba, Argentina. 17. Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Austral University, School of Medicine, avenue Presidente-Perón 1500, (B1629HJ) Pilar, Buenos Aires, Argentina.
Abstract
BACKGROUND AND AIM: Non-alcoholic fatty liver disease (NAFLD) is an increasing cause of hepatocellular carcinoma (HCC) and liver transplantation (LT). Our study focused on changing trends of liver related HCC etiologies during the last years in Latin America. METHODS: From a cohort of 2761 consecutive adult LT patients between 2005 and 2012 in 17 different centers, 435 with HCC were included. Different periods including years 2005-2006, 2007-2008, 2009-2010 and 2011-2012 were considered. Etiology of liver disease was confirmed in the explant. RESULTS: Participating LT centers per country included 2 from Brazil (n=191), 5 transplant programs from Argentina (n=98), 2 from Colombia (n=65), 4 from Chile (n=49), 2 from Mexico (n=12), and 1 from Peru (n=11) and Uruguay (n=9). Chronic hepatitis C infection was the leading cause of HCC in the overall cohort (37%), followed by HBV (25%) and alcoholic liver disease (17%). NAFLD and cryptogenic cirrhosis accounted for 6% and 7%, respectively. While HCV decreased from 48% in 2005-06 to 26% in 2011-12, NAFLD increased from 1.8% to 12.8% during the same period, accounting for the third cause of HCC. This represented a 6-fold increase in NAFLD-HCC, whereas HCV had a 2-fold decrease. Patients with NAFLD were older, had lower pre-LT serum AFP values and similar 5-year survival and recurrence rates than non-NAFLD. CONCLUSION: There might be a global changing figure regarding etiologies of HCC in Latin America. This epidemiological change on the incidence of HCC in the world, although it has been reported, should still be confirmed in prospective studies.
BACKGROUND AND AIM: Non-alcoholic fatty liver disease (NAFLD) is an increasing cause of hepatocellular carcinoma (HCC) and liver transplantation (LT). Our study focused on changing trends of liver related HCC etiologies during the last years in Latin America. METHODS: From a cohort of 2761 consecutive adult LT patients between 2005 and 2012 in 17 different centers, 435 with HCC were included. Different periods including years 2005-2006, 2007-2008, 2009-2010 and 2011-2012 were considered. Etiology of liver disease was confirmed in the explant. RESULTS: Participating LT centers per country included 2 from Brazil (n=191), 5 transplant programs from Argentina (n=98), 2 from Colombia (n=65), 4 from Chile (n=49), 2 from Mexico (n=12), and 1 from Peru (n=11) and Uruguay (n=9). Chronic hepatitis C infection was the leading cause of HCC in the overall cohort (37%), followed by HBV (25%) and alcoholic liver disease (17%). NAFLD and cryptogenic cirrhosis accounted for 6% and 7%, respectively. While HCV decreased from 48% in 2005-06 to 26% in 2011-12, NAFLD increased from 1.8% to 12.8% during the same period, accounting for the third cause of HCC. This represented a 6-fold increase in NAFLD-HCC, whereas HCV had a 2-fold decrease. Patients with NAFLD were older, had lower pre-LT serum AFP values and similar 5-year survival and recurrence rates than non-NAFLD. CONCLUSION: There might be a global changing figure regarding etiologies of HCC in Latin America. This epidemiological change on the incidence of HCC in the world, although it has been reported, should still be confirmed in prospective studies.
Authors: Luis Antonio Díaz; Gustavo Ayares; Jorge Arnold; Francisco Idalsoaga; Oscar Corsi; Marco Arrese; Juan Pablo Arab Journal: Curr Treat Options Gastroenterol Date: 2022-06-16