Hepatocellular carcinoma incidence high in patients with alcoholic cirrhosis
Hepatocellular carcinoma (HCC) is relatively common in patients with alcoholic cirrhosis, reports a new study.
Researchers evaluated 652 patients (median age 58.4 years; 68 percent male) with biopsy-confirmed compensated alcoholic cirrhosis, in whom the incidence of HCC was monitored. Other study outcomes included overall survival, event-free survival, liver-related mortality and hepatic focal lesions.
Majority of the participants (67.6 percent; n=441) were completely abstinent from alcohol, with a median duration of withdrawal of 24.7 months. At baseline, 44 patients (6.7 percent) had benign focal liver lesions, which were determined to be nonhepatocellular in 23, and hepatocellular in 11.
Over a median follow-up duration of 29 months, 125 patients developed liver lesions. The resulting 1- and 2-year cumulative incidence estimates were 13.3 percent and 20.8 percent, respectively. Most of these lesions remained benign, with only 43 patients (6.6 percent) eventually being diagnosed with HCC.
Researchers calculated the incidence rate of HCC to be 2.9 per 100 patient-years. The 1- and 2-year cumulative incidence rates were 1.8 percent and 5.2 percent, respectively.
Overall, majority of participants (77 percent; n=33) fulfilled the Milan criteria, but only 56 percent (n=24) ever received first-line curative treatment, such as liver transplantation, surgical resection and percutaneous ablation. Other patients opted for second-line liver treatments such as embolization and radiotherapy.
Seventy-three deaths were recorded, yielding a 2-year survival rate of 93 percent. Liver disease (44 percent; n=27) and liver decompensation (n=19) were the most prominent causes of death.