Risk Factors in Development of Hepatocellular Carcinoma in Cirrhosis: Prospective Study of 613 Patients

Sn, Zaman; Wm, Melia; Rd, Johnson; Portmann, B; Pj, Johnson; Williams, Roger

doi:10.1016/s0140-6736(85)91785-4

Cited by 244 publications

(115 citation statements)

References 17 publications

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“…Although strongly associated with the presence of HBsAg, the overall proportion of 30.0% of cirrhosis is much lower than reported frequencies of 60% to 80% 7,13,18 . This may be due to the fact that histological diagnosis followed percutaneous liver biopsies in the majority of cases.…”

Section: Discussioncontrasting

confidence: 63%

A case-control study on the association of hepatitis B virus infection and hepatocellular carcinoma in Northeast Brazil

Cotrim

Mota

Leite³

et al. 1992

Rev. Saúde Pública

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COTRIM, H. et al. A case-control study on the association of hepatitis B virus infection and hepatocellular carcinoma in Northeast Brazil. Rev. Saúde públ, S.Paulo, 26: 301-5, 1992. Hepatitis B virus (HBV) serological markers were investigated in 40 incident cases of hepatocellular carcinoma (HCC) and in two age and sex matched control groups, comprising 40 patients with other cancers and 80 healthy individuals, resident in Bahia, Brazil. Serologic tests were done by radioimmunoassay. The study observed high proportion of seropositivity to HBsAg (42.5%) and of those presenting HBsAg or antiHBc (65.0%) among HCC cases, higher in men than women and in those aged 17 to 30 years old. HBsAg seropositivity among HCC patients was greater than in the control group with other cancers (7.5%) and in healthy controls (2.5%), corresponding to odds ratio estimates of 15.0 (95% CI 3.29, 68.30) and 33.0 (95% CI 9.13, 119.28), both statistically significant. HBeAg was not observed and antiHBe was present in 41.2% of cases, suggesting the absence of viral replication, possibly with viral DNA intergration into the hepatocyte genome. The presence of cirrhosis was associated with HBsAg seropositivity among HCC cases. A history of chronic alcoholism is shown to be more frequently related to those cases with cirrhosis. This study highlights the relevant association between HCC and HBV in Northeast Brazil, particularly for young individuals, and the high risk of development of HCC for HBsAg carriers.

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Section: Discussioncontrasting

confidence: 63%

A case-control study on the association of hepatitis B virus infection and hepatocellular carcinoma in Northeast Brazil

Cotrim

Mota

Leite³

et al. 1992

Rev. Saúde Pública

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“…The severe prognosis of patients with HBV-related disease in comparison with the HCV-positive ones has been already recognized (Zaman et al, 1985;Villa et al, 1988). It is possible that in the present series this finding may be due to the preselection of patients with HCC characterized by variant ER receptors transcripts: these subjects are in fact significantly more often HBsAg-positive than HCV-positive (Villa et al, 1998).…”

Section: Discussionmentioning

confidence: 93%

Hormonal therapy with megestrol in inoperable hepatocellular carcinoma characterized by variant oestrogen receptors

et al. 2001

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Summary Variant liver oestrogen receptor transcripts in hepatocellular carcinoma are associated with aggressive clinical course and unresponsiveness to tamoxifen. To evaluate the impact on survival and on tumour growth of megestrol (progestin drug acting at postreceptorial level) we enrolled 45 patients with HCC characterized by variant liver oestrogen receptors in a prospective, randomized study with megestrol vs. placebo. Presence of variant oestrogen receptors was determined by RT/PCR. 24 patients were randomized to no treatment and 21 to therapy with megestrol 160 mg day -1 . Results were analysed by Kaplan-Meier and Cox methods. Survival of hepatocellular carcinoma characterized by variant oestrogen receptors was extremely poor (median survival 7 months); megestrol significantly improved survival (18 months) (P = 0.0090). Tumour growth at one year was significantly slowed down in megestrol-treated patients (P = 0.0212). Bilirubin levels, presence of portal thrombosis, HBV aetiology and treatment were identified at univariate analysis as factors significantly associated with survival; at multivariate analysis, only megestrol therapy (P = 0.0003), presence of HBV infection (P = 0.0009) and presence of portal vein thrombosis (P = 0.0051) were factors independently related with survival. (1) Megestrol slows down the aggressive tumour growth of patients with hepatocellular carcinoma characterized by variant estrogen receptors and (2) is also able to favourably influence the course of disease, more than doubling median survival.

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“…The annual risk of developing HCC in cirrhosis is between 1% and 6%. [14][15][16][23][24][25][26][27][28][29] Although several studies have shown that the risk of HCC is higher in patients with cirrhosis caused by viral infection compared with nonviral causes, 14,16,28,29 a high rate of HCC has also been reported in patients with cirrhosis caused by genetic hemochromatosis. 30 In contrast, low incidence rates are seen in biliary cirrhosis.…”

Section: The Target Population Must Be Easily Identifiablementioning

confidence: 99%

Screening for hepatocellular carcinoma

1998

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Risk Factors in Development of Hepatocellular Carcinoma in Cirrhosis: Prospective Study of 613 Patients

Cited by 244 publications

References 17 publications

A case-control study on the association of hepatitis B virus infection and hepatocellular carcinoma in Northeast Brazil

A case-control study on the association of hepatitis B virus infection and hepatocellular carcinoma in Northeast Brazil

Hormonal therapy with megestrol in inoperable hepatocellular carcinoma characterized by variant oestrogen receptors

Screening for hepatocellular carcinoma

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