Probability of liver cancer and survival in HCV-related or alcoholic-decompensated cirrhosis. A study of 377 patients

• Published in: Liver international Vol. 26; no. 1; pp. 62 - 72
• Main Authors: Solà, Ricard, Álvarez, Marco Antonio, Ballesté, Belén, Montoliu, Silvia, Rivera, Mònica, Miquel, Mireia, Cirera, Isabel, Morillas, Rosa Maria, Coll, Susanna, Planas, Ramon
• Format: Journal Article
• Language: English
• Published: Oxford, UK Munksgaard International Publishers 01.02.2006
• Subjects: Age Distribution; Aged; alcoholic cirrhosis; Cause of Death; Cohort Studies; Disease Progression; Female; HCV-related cirrhosis; Hepatitis C, Chronic - diagnosis; Hepatitis C, Chronic - mortality; Hepatitis C, Chronic - therapy; Humans; Incidence; Italy - epidemiology; liver cancer; Liver Cirrhosis, Alcoholic - diagnosis; Liver Cirrhosis, Alcoholic - mortality; Liver Cirrhosis, Alcoholic - therapy; Liver Function Tests; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Liver Neoplasms - therapy; Male; Middle Aged; natural history; Probability; Proportional Hazards Models; Retrospective Studies; Risk Assessment; Severity of Illness Index; Sex Distribution; survival; Survival Analysis; Italy
• ISSN: 1478-3223; 1478-3231
• DOI: 10.1111/j.1478-3231.2005.01181.x

: Background: Although chronic alcohol intake and chronic hepatitis C may progress to cirrhosis and hepatocellular carcinoma (HCC), few data are available about survival and probability of developing HCC in decompensated cirrhosis of both aetiologies. Methods: This study identified factors related with probability of developing HCC and survival in a cohort of 377 consecutive patients with decompensated HCV‐related cirrhosis (200 cases) or alcoholic cirrhosis (177 cases) without known HCC, hospitalized for their first hepatic decompensation, as well as to evaluate differences between both aetiologies. Patients were followed for a mean period of 39±2 months. Results: During follow‐up, 42 patients (11.1%) developed HCC (16.5% vs 5.1%) in groups HCV and alcohol, respectively; p=0.0008), and 131 patients (34.7%) died (42% vs 26.6% in groups HCV and alcohol, respectively; p=0.002). Age and HCV‐cirrhosis were independently related to HCC development, while baseline age and Child‐Turcotte‐Pugh score were independently correlated with survival. Conclusion: Survival in decompensated HCV‐related or alcoholic cirrhosis is influenced by age and baseline Child‐Turcotte‐Pugh score, without differences in cirrhosis aetiology. The risk of developing HCC is greater in HCV‐related cirrhosis than in alcoholic cirrhosis.