Effect of the Etiology of Viral Cirrhosis on the Survival of Patients with Hepat

January 7, 2006

The American Journal of Gastroenterology

Volume 101 Page 91 - January 2006

doi:10.1111/j.1572-0241.2006.00364.x

Volume 101 Issue 1

Effect of the Etiology of Viral Cirrhosis on the Survival of Patients with

Hepatocellular Carcinoma

Chiara Cantarini, M.D.1, Franco Trevisani, M.D.1,

Morselli-Labate, Ph.D.2, Gianludovico Rapaccini, M.D.3, Fabio Farinati,

M.D.4, Paolo Del Poggio, M.D.5, Di Nolfo, M.D.6, a Benvegnù,

M.D.7, Marco Zoli, M.D.1, Franco Borzio, M.D.8, and Mauro Bernardi, M.D.1

for the Italian Liver Cancer (ITA.LI.CA) group.

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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