Risk and outcome of hepatocellular carcinoma in liver cirrhosis in Southern Sweden: a population-based study

被引:15
作者
Nilsson, Emma [1 ,2 ]
Anderson, Harald [3 ]
Sargenti, Konstantina [1 ,2 ]
Lindgren, Stefan [2 ,4 ]
Prytz, Hanne [1 ,2 ]
机构
[1] Lund Univ, Dept Clin Sci, Lund, Sweden
[2] Lund Univ, Skane Univ Hosp, Gastroenterol Clin, Lund, Sweden
[3] Lund Univ, Dept Clin Sci, Canc Epidemiol, Lund, Sweden
[4] Lund Univ, Dept Clin Sci, Malmo, Sweden
关键词
cirrhosis; decompensation; survival; population-based cohort; alcohol; hepatitis C; hepatocellular carcinoma; TERM-FOLLOW-UP; LONG-TERM; CLINICAL PRESENTATION; HEPATITIS; CANCER;
D O I
10.1080/00365521.2019.1649454
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and aims: Liver cirrhosis is a risk factor for hepatocellular carcinoma (HCC). While the HCC risk is thought to be highest in hepatitis B and hepatitis C, the risk in other cirrhosis etiologies is not fully established. Therefore, we aimed to study the risk and outcome of HCC in alcoholic cirrhosis compared to cirrhosis of other etiologies, in Sweden. Material and methods: We used population-based medical registries to identify patients diagnosed with cirrhosis in the Scania region in southern Sweden between 2001 and 2010. Medical records were reviewed to identify all HCC cases and to register clinical parameters. All patients were followed until death, emigration or December 2017. Results: The cohort comprised 1317 patients with cirrhosis. A total of 200 patient developed HCC, including 75 with prevalent HCC. The annual incidence of HCC after six months was 1.5% in alcoholic cirrhosis and 4.7% in hepatitis C cirrhosis. In alcoholic cirrhosis, 40 patients were diagnosed with HCC during follow-up, of which 15 patients fulfilled the Milan criteria and 10 received treatment, curative or palliative. The overall median survival after HCC diagnosis was 7.7 months, with 4.5, 11 and 9.3 months, in cirrhosis due to alcohol, hepatitis C or remaining causes, respectively. Conclusion: We find an annual incidence of HCC in alcoholic cirrhosis of 1.5% indicating need for surveillance in these patients. Survival after HCC diagnosis was worst in alcoholic cirrhosis due to more advanced stage at diagnosis with few patients eligible for treatment.
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收藏
页码:1027 / 1032
页数:6
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