COMPARABLE FREQUENCY OF HEPATOCELLULAR-CARCINOMA IN CIRRHOSIS OF DIFFERENT ETIOLOGY

Objective: To evaluate by multivariate analysis whether the risk of hepatocellular carcinoma (HCC) varies in cirrhosis of different aetiology. Design: Cohort study of patients monitored every 6 months by laboratory tests and ultrasonography. Setting: Three northern Italian hospitals. Patients: A total of 396 patients (285 men and 111 women; median age, 58 years) with cirrhosis (253 with Child's class A and 143 class B or C) attributable to alcohol abuse, chronic infection by hepatitis B or non-A non-B virus (hepatitis C virus in 79% of patients) and iron overload due to genetic haemochromatosis, were followed for 1-245 months (median, 50 months). Methods: Cox's regression model was used to evaluate sex, age, Child's class, and aetiology of cirrhosis as independent risk factors for HCC; interactions between aetiologic factors were also considered. Results: During follow-up, 143 patients died and 63 developed HCC. The cumulative probability of remaining free of HCC was 90, 80 and 68% at 2, 6 and 10 years. Age 58 years or more (hazard ratio, 4.26 versus age < 58 years; P < 0.001) and Child's class B or C (hazard ratio, 1.81 versus Child's class A; P < 0.05) increased the risk of HCC. Conclusion: The aetiology of cirrhosis, when corrected for age, sex and the severity of cirrhosis, did not significantly affect the risk of HCC development.