Incidence and Predictors of Hepatocellular Carcinoma in Patients With Cirrhosis

Ioannou, George N.; Splan, Meaghan F.; Weiss, Noel S.; McDonald, George B.; Beretta, Laura; Lee, Sum P.

doi:10.1016/j.cgh.2007.02.039

Cited by 265 publications

(215 citation statements)

References 40 publications

(23 reference statements)

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“…Due to a low number of patients, we could not show significant link with other known predictive factors (esophageal varices and bilirubin serum levels 0.05 < P < 0.08). Conversely, as previous studies in patients with HCV-cirrhosis, we did not identify male gender [16,19] , high AFP serum level [14,17] , low platelet count [14,16,19] and diabetes [21] as predictive factors for the occurrence of HCC. These results, observed in Caucasians, may be different in other ethnic groups.…”

Section: Discussioncontrasting

confidence: 76%

“…In these patients, the annual incidence of HCC varies from 2% to 6% [8][9][10][11][12][13] . The main predictive factors of HCC in patients with HCV-cirrhosis are age over 50 [14][15][16][17] , male gender [12,14,15,17] , increased serum alpha-fetoprotein (AFP) baseline levels [12,18,19] , symptoms of portal hypertension, such as thrombopenia [17,18] or esophageal varices [17,19] , obesity [20,21] and diabetes [22,23] . Identification of molecular abnormalities associated with an increased risk of HCC is particularly important to improve knowledge of both the pathways of liver carcinogenesis and the outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Liver insulin-like growth factor 2 methylation in hepatitis C virus cirrhosis and further occurrence of hepatocellular carcinoma

Couvert¹,

Carrié²,

Pariès³

et al. 2008

WJG

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A and Beaugrand M designed research; Nahon P selected patients; Pariès J analyzed data; Vaysse J tested IGF2 serum level; Couvert P, Kerjean A, Miroglio A and Chelly J performed molecular analyses; Couvert P and Ganne-Carrié N wrote the paper. Abstract AIM: To assess the predictive value of the insulinlike growth factor 2 (Igf2 ) methylation profile for the occurrence of Hepatocellular Carcinoma (HCC) in hepatitis C (HCV) cirrhosis. M E T H O D S : Pat ie nt s w i t h:(1) biops y-prove n compensated HCV cirrhosis; (2) available baseline frozen liver sample; (3) absence of detectable HCC; (4) regular screening for HCC; (5) informed consent for genetic analysis were studied. After DNA extraction from liver samples and bisulfite treatment, unbiased PCR and DHPLC analysis were performed for methylation analysis at the Igf2 locus. The predictive value of the Igf2 methylation profile for HCC was assessed by Kaplan-Meier and Cox methods. RESULTS: Among 94 included patients, 20 developed an HCC during follow-up (6.9 ± 3.2 years). The methylation profile was hypomethylated, intermediate and hypermethylated in 13, 64 and 17 cases, respectively. In univariate analysis, two baseline parameters were associated with the occurrence of HCC: age (P = 0.01) and prothrombin (P = 0.04). The test of linear tendency between the three ordered levels of Igf2 methylation and probability of HCC occurrence was significant (Log Rank, P = 0.043; Breslow, P = 0.037; Tarone-Ware, P = 0.039). CONCLUSION:

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Section: Discussioncontrasting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Liver insulin-like growth factor 2 methylation in hepatitis C virus cirrhosis and further occurrence of hepatocellular carcinoma

Couvert¹,

Carrié²,

Pariès³

et al. 2008

WJG

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“…This is in accordance with previous findings that describe higher risk in patients with hepatitis infection 23 in addition to older age, male gender, severity of liver disease and alcoholic liver disease. 24,25 Former studies also suggest TIPS to be associated with an increased risk of HCC.…”

supporting

confidence: 93%

Is de novo hepatocellular carcinoma after transjugular intrahepatic portosystemic shunt increased?

Hüsing‐Kabar

Meister

Köhler

et al. 2017

United European Gastroenterology Journal

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Background: Portal hypertension is a major complication of liver cirrhosis. Transjugular intrahepatic portosystemic shunt is effective in treatment of portal hypertension. However, decreased parenchymal portal venous flow after transjugular intrahepatic portosystemic shunt insertion favours ischaemic liver injury which has been discussed to induce hepatocarcinogenesis causing hepatocellular cancer. Aim: This study aimed to explore the association between transjugular intrahepatic portosystemic shunt placement and the development of hepatocellular cancer. Methods: A total of 1338 consecutive liver cirrhosis patients were included in this retrospective study between January 2004-December 2015. Data were analysed with regard to development of hepatocellular cancer during follow-up. Binary logistic regression and Kaplan-Meier analyses were conducted for the assessment of risk factors for hepatocellular cancer development. In a second step, to rule out confounders of group heterogeneity, case-control matching was performed based on gender, age, model of end-stage liver disease score and underlying cause of cirrhosis (non-alcoholic steatohepatitis, alcoholic liver disease and viral hepatitis). Results: Besides established risk factors such as older age, male gender and underlying viral hepatitis, statistical analysis revealed the absence of transjugular intrahepatic portosystemic shunt insertion as a risk factor for hepatocellular cancer development. Furthermore, matched-pair analysis of 432 patients showed a significant difference (p ¼ 0.003) in the emergence of hepatocellular cancer regarding transjugular intrahepatic portosystemic shunt placement versus the nontransjugular intrahepatic portosystemic shunt cohort. Conclusion: In patients with end-stage liver disease, transjugular intrahepatic portosystemic shunt insertion is significantly associated with reduced rates of hepatocellular cancer development.

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“…Those factors include alcoholrelated cirrhosis of the liver 14,15 , fatty liver disease associated with obesity 16,17 , diabetes 18 , smoking 19 , and oral contraceptives 20 . Less-common risk factors include hereditary hemachromatosis, α1-antitrypsin deficiency, primary biliary cirrhosis, autoimmune hepatitis, Wilson disease, and nonalcoholic steatohepatitis 20 .…”

Section: Introductionmentioning

confidence: 99%

Canadian Trends in Liver Cancer: A Brief Clinical and Epidemiologic Overview

Dryer²,

Otterstatter

et al. 2013

Current Oncology

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1980 and 2007 5 and is projected to increase into the future 6 . An examination of age-specific incidence rates in men shows the highest incidence occurring among those 70-79 years of age, although statistically significant rate increases have occurred in all age groups examined (that is, 40+ years) since 1980 ( Figure 2). The death rate has followed a similar upward trajectory, reflecting the poor prognosis with this cancer and the late-stage at which it is commonly detected 7 . The 5-year relative survival in all stages of the disease is currently only 18% in Canada 8 . RISK FACTORSThe major risk factor for primary liver cancer is infection with viral hepatitis. Chronic infection with hepatitis B virus (hbv) accounts for approximately 23% of hcc cases in developed countries, but the percentage is much higher in the developing world, including Southeast Asia and sub-Saharan Africa 9 . ABSTRACTAlthough primary liver cancer is rare, its incidence rate has been rising quickly in Canada, more than tripling since the early 1980s. This cancer is more common in men than women, and the age-specific incidence rates in men have been increasing significantly in all age groups from 40 years of age onward. The death rate has followed a similar upward trajectory, in part because of the low 5-year survival rate of 18% in both sexes. Infection with the hepatitis B or C virus continues to be the most common risk factor, but other factors may also play a role. Risk reduction strategies, such as viral hepatitis screening, have been recommended in other countries and warrant consideration in Canada as part of a coordinated strategy of disease prevention and control.

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Incidence and Predictors of Hepatocellular Carcinoma in Patients With Cirrhosis

Cited by 265 publications

References 40 publications

Liver insulin-like growth factor 2 methylation in hepatitis C virus cirrhosis and further occurrence of hepatocellular carcinoma

Liver insulin-like growth factor 2 methylation in hepatitis C virus cirrhosis and further occurrence of hepatocellular carcinoma

Is de novo hepatocellular carcinoma after transjugular intrahepatic portosystemic shunt increased?

Canadian Trends in Liver Cancer: A Brief Clinical and Epidemiologic Overview

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