Clinical Characteristics and Time Trends in Etiology of Hepatocellular Cancer in Germany

Schütte, Kerstin; Kipper, Matthias; Kahl, Stefan; Bornschein, Jan; Götze, Tobias; Adolf, Daniela; Arend, Jörg; Seidensticker, Ricarda; Lippert, H.; Ricke, Jens; Malfertheiner, Peter

doi:10.1159/000346743

Cited by 36 publications

(26 citation statements)

References 86 publications

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“…The prevalence of HCC-NC in this Brazilian study was elevated (16%), and the results were similar to those found in other studies conducted in Western countries [6][7][8] . The patients were most frequently of advanced ages (mean of 64.4 years) and predominately male.…”

Section: Discussionsupporting

confidence: 91%

“…In Western countries, the prevalence of hepatocellular carcinoma in non-cirrhosis (HCC-NC) patients was estimated in 15% to 20% of cases [6][7][8] , and the most common risk factors were HBV and HCV. However, a majority of the information was obtained from Asia and Africa, where the prevalence of hepatitis B and C viral infections is also elevated [9][10][11] .…”

Section: Introductionmentioning

confidence: 99%

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Hepatocellular carcinoma in patients without cirrhosis: relevance and clinical characteristics

Carvalho¹,

Fonseca²,

Cotrim³

2018

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Aim: The present study evaluated the frequency of hepatocellular carcinoma (HCC) in patients without cirrhosis.Methods: HCC patients were recruited from two reference centers for liver disease in Northeast Brazil from 2010 to 2016. The diagnosis of HCC and cirrhosis was based on international criteria. Results:A total of 169 patients were included, and 16% (27) of the patients did not have hepatocellular carcinoma in non-cirrhosis (HCC-NC). The mean age of HCC-NC was 64.4 ± 11.3 years, and 74.1% of the patients were male. The main risk factors were hepatitis C virus (HCV) in 29.6% (8), nonalcoholic steatohepatitis (NASH) in 14.8% (4) and hepatitis B virus (HBV) in 11.1% (3). Histological HCC diagnosis was performed in 81.5% (22) of the patients, and in 18.5% (5) of these patients, the diagnosis was performed by ultrasonography, computed tomography or nuclear magnetic resonance imaging methods. Single nodules were found in 56% of HCC-NC (14) when assessed by imaging methods. Conclusion:The frequency of HCC-NC was elevated and more common in males. HCV, NASH and HBV were the most frequent risk factors. These data contribute to discussion on future protocols and criteria for the early diagnosis and treatment of HCC in patients with chronic liver disease without cirrhosis.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Hepatocellular carcinoma in patients without cirrhosis: relevance and clinical characteristics

Carvalho¹,

Fonseca²,

Cotrim³

2018

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“…Analyses of transplants from the ELTR demonstrated that NAFLD may be under-recognized as an indicator for liver transplant, with many transplants classified simply as cirrhosis or HCC [36]. Studies of transplant recipients in Sweden and Germany report that over 40% of cases classified as cryptogenic cirrhosis were NASH-related [37] and NASH was the third leading cause of HCC resulting in transplantation [38]. In the US, there is evidence that numerous transplants indicated for cryptogenic or idiopathic cirrhosis are NAFLD-related based on obesity rates in this population [39,40].…”

Section: New Nafld Casesmentioning

confidence: 99%

Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016–2030

Estes

Anstee

Arias-Loste

et al. 2018

Journal of Hepatology

1,330

817

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Background: Nonalcoholic fatty liver disease (NAFLD) with resulting nonalcoholic steatohepatitis (NASH) are increasingly a cause of cirrhosis and hepatocellular carcinoma (HCC) globally. This burden is expected to increase as epidemics of obesity, diabetes and metabolic syndrome continue to grow. The goal of this analysis was to use a Markov model to forecast NAFLD disease burden using currently available data. Methods:A model was used to estimate NAFLD and NASH disease progression in 8 countries based on data for adult prevalence of obesity and type 2 diabetes mellitus (DM). Published estimates and expert consensus were used to build and validate the model projections. Results:If obesity and DM level off in the future, we project a modest growth in total NAFLD cases (0-30%), between 2016-2030, with the highest growth in China as result of urbanization and the lowest growth in Japan as result of a shrinking population.However, at the same time, NASH prevalence will increase 15-56%, while liver mortality and advanced liver disease will more than double as result of an aging/increasing population.Conclusions: NAFLD and NASH represent a large and growing public health problem and efforts to understand this epidemic and to mitigate the disease burden are needed.If obesity and DM continue to increase at current and historical rates, both NAFLD and 4 NASH prevalence are expected to increase. Since both are reversible, public health campaigns to increase awareness and diagnosis, and to promote diet and exercise can help manage the growth in future disease burden.Lay summary: Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) can lead to advanced liver disease, and are occurring in increasing numbers in tandem with epidemics of obesity and diabetes. A mathematical model was built to understand how the disease burden associated with NAFLD and NASH will change over time. Results suggest increasing numbers of cases of advanced liver disease and liver-related mortality in the coming years. 5 BACKGROUNDNonalcoholic fatty liver disease (NAFLD) is a leading cause of liver disease globally [1][2][3]. This condition is characterized by excess liver fat in the absence of other causes such as alcohol consumption [4,5]. Obesity, type 2 diabetes mellitus (DM) and metabolic syndrome (MetS) are consistently identified as the most important risk factors for NAFLD [4,6].In order to classify the population, NAFLD may be divided into two groups: NAFL (steatosis only) or NASH (nonalcoholic steatohepatitis), where steatosis is accompanied by inflammation and ballooning. NASH frequently progresses to liver fibrosis [7] that is the main risk factor for liver-related mortality [8]. Odds of progression to advanced liver disease, including hepatic decompensation and hepatocellular carcinoma (HCC), are higher among those with NASH compared to those with NAFL [7]. Increasing age, obesity, DM and the presence of NASH have been consistently identified as risk factors for progression to cirrhosis [6,9].There is a...

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“…The liver is the central organ involved in the metabolism of nutrients, and in patients with liver cirrhosis malnutrition is a common attribute and associated with mortality and reduced quality of life [5]. In case of HCC, that in the majority of cases is associated with liver cirrhosis [6,7], tumor progression and tumor directed therapies can directly impact on liver function additionally [8].…”

Section: Introductionmentioning

confidence: 99%

Malnutrition is a prognostic factor in patients with hepatocellular carcinoma (HCC)

et al. 2015

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Clinical Characteristics and Time Trends in Etiology of Hepatocellular Cancer in Germany

Cited by 36 publications

References 86 publications

Hepatocellular carcinoma in patients without cirrhosis: relevance and clinical characteristics

Hepatocellular carcinoma in patients without cirrhosis: relevance and clinical characteristics

Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016–2030

Malnutrition is a prognostic factor in patients with hepatocellular carcinoma (HCC)

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