Am J Gastroenterol. 2006 Jan;101(1):91-8.
Effect of the etiology of viral cirrhosis on the survival of patients with hepatocellular carcinoma.
Cantarini MC, Trevisani F, Morselli-Labate AM, Rapaccini G, Farinati F, Poggio PD, Nolfo MA, Benvegnu L, Zoli M, Borzio F, Bernardi M; for the Italian Liver Cancer (ITA.LI.CA) group.
Dipartimento di Medicina Interna, Cardioangiologia, Epatologia, Alma Mater Studiorum-University of Bologna, Bologna, Italy.
OBJECTIVES: The aim of this study was to assess whether hepatocellular carcinoma occurring in the setting of hepatitis B or C virus infection has different prognosis.
METHODS: We performed a multicentric case-control study comparing 102 pairs of patients affected by hepatitis B virus- or hepatitis C virus-related hepatocellular carcinoma. Patients were matched for sex (male/female: 84/18 pairs), age, center, and period of enrollment, underlying chronic liver disease (cirrhosis/chronic hepatitis: 97/5 pairs), Child-Pugh class (A/B/C: 70/25/7 pairs), hepatocellular carcinoma stage (nonadvanced/advanced: 50/52 pairs) and, when possible, modality of cancer diagnosis (75 pairs: 47 during and 28 outside surveillance).
RESULTS: In the whole population, patients with hepatitis B tended to have a poor prognosis than those with hepatitis C (p= 0.160), and this difference became statistically significant among the patients with an advanced hepatocellular carcinoma (p= 0.025). Etiology, Child-Pugh class, gross pathology, and alpha-fetoprotein were the significant independent prognostic factors in the whole population. The distribution of these prognostic factors did not differ between patients with hepatitis B or hepatitis C, both in the whole population and in the subgroup of advanced hepatocellular carcinomas.
CONCLUSION: Hepatitis
B virus-related hepatocellular carcinomas have a greater aggressiveness than
hepatitis C virus-related tumors, which becomes clinically manifest once they
have reached an advanced stage. (Am J Gastroenterol 2006;101:91-98).
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