Comparison between alcohol‐ and hepatitis C virus‐related hepatocellular carcinoma: clinical presentation, treatment and outcome

Abstract

SUMMARY BackgroundHepatitis C virus (HCV) and alcohol abuse are the main risk factors for hepatocellular carcinoma (HCC) in Western countries.

Hepatocellular carcinoma is diagnosed at a later stage in alcoholic patients: Results of a prospective, nationwide study

“…10,11 Various assumptions can be made to explain why patients with alcohol-related HCC have reduced survival in comparison with patients with non-alcohol-related HCC: a diagnosis at a later stage due to lower rates of HCC screening, worse liver function and/or ongoing alcohol consumption preventing curative options, and discrimination against alcoholic patients leading to less aggressive treatment options. 10,11 Various assumptions can be made to explain why patients with alcohol-related HCC have reduced survival in comparison with patients with non-alcohol-related HCC: a diagnosis at a later stage due to lower rates of HCC screening, worse liver function and/or ongoing alcohol consumption preventing curative options, and discrimination against alcoholic patients leading to less aggressive treatment options.…”

“…Although alcohol is a dominant risk factor associated with HCC in certain parts of the world, 19,20 specific clinical data on alcohol-related HCC are scarce. 10,11 Various assumptions can be made to explain why patients with alcohol-related HCC have reduced survival Cancer in comparison with patients with non-alcohol-related HCC: a diagnosis at a later stage due to lower rates of HCC screening, worse liver function and/or ongoing alcohol consumption preventing curative options, and discrimination against alcoholic patients leading to less aggressive treatment options. In our study, cirrhosis was unrecognized before the HCC diagnosis more frequently in alcoholic patients, and this confirmed a previous report.…”

“…7 The annual incidence of HCC in patients with alcoholic liver cirrhosis is 1% to 2%. 10,11 The CHANGH cohort (cohorte de Carcinomes Hepatocelulaires de l'Association des h epato-Gastroent erologues des Hôpitaux G en eraux) was a French prospective, observational cohort study that collected data on the clinical features and treatment allocations of patients with newly diagnosed HCC. 8,9 Recent retrospective studies suggest that the tumor stage at diagnosis is influenced by the etiology, with alcoholrelated HCC being diagnosed at a later stage.…”

“…8,9 Recent retrospective studies suggest that the tumor stage at diagnosis is influenced by the etiology, with alcoholrelated HCC being diagnosed at a later stage. 10,11 The CHANGH cohort (cohorte de Carcinomes Hepatocelulaires de l'Association des h epato-Gastroent erologues des Hôpitaux G en eraux) was a French prospective, observational cohort study that collected data on the clinical features and treatment allocations of patients with newly diagnosed HCC. In this cohort, alcoholrelated HCC was predominant.…”

The Changing Epidemiology of Hepatocellular Carcinoma : Experience of a Single Center

“…Although nonalcoholic steatohepatitis (NASH), autoimmune, and cholestatic diseases predispose to HCC onset, they seem to play a minor role [10]. However, in recent years, the epidemiological scenario has been changing: there is a lower severity of the disease at diagnosis [7], a reduction in HCC incidence in areas with a traditionally high prevalence, such as East Asia, but an increase in low prevalence areas [11][12][13]. Indeed, in geographical areas with the highest HCC incidence, such as China and Eastern Sub-Saharan Africa, a reduction in the number of new cases of the disease was observed in the 1990-2015 time interval, probably attributable not only to vaccination programs but also to a lower exposure to the predominant causal factors in these areas, such as aflatoxins [14].…”