Risk factors for hepatocellular carcinoma in patients with cirrhosis

[Guest guest]

Dig Dis Sci. 2004 May;49(5):850-3.

Risk factors for hepatocellular carcinoma in patients with cirrhosis.

Sarbah SA, Gramlich T, Younoszai A, Osmack P, Goormastic M, Grosso L,

JN, Di Bisceglie A, Seneca R, Younossi ZM.

Center for Liver Diseases at Inova Fairfax Hospital, Falls Church, Virginia

22042, USA.

Recent research suggests an increase in the incidence of hepatocellular

carcinoma (HCC) in the United States, which may be related to an upsurge in

the sequelae of chronic liver disease from hepatitis C virus. In addition to

factors related to the underlying etiology of liver disease, a number of

host factors such as age, gender, and ethnic background may be associated

with this increased risk. The aim of this study was to evaluate a number of

potential risk factors for HCC in patients with cirrhosis. Patients with

biopsy proven HCC were identified from our pathology and cancer registry

databases. All those without histologic or clinical cirrhosis and non-HCC

hepatic malignancies were excluded. Cirrhotic patients without HCC were also

selected from the Cleveland Clinic unified transplant database and were

designated controls. Extensive clinicodemographic data were obtained from

the databases and chart reviews. When available, paraffin-embedded liver

biopsy blocks were obtained for HFE gene analysis. Univariate comparisons

were made with chi-square and Fisher's exact test and multivariate analysis

was carried out with logistic regression. A total of 760 patients were

included in this study, 244 documented cases of HCC and 516 cirrhotic

controls without HCC. Patients' age (RR = 3.1 [2.6-3.8]; P < 0.0001), male

gender (RR = 3.4 [2.3-5.1]; P < 0.0001), African-American ethnicity (RR =

3.1 [1.6-5.8]; P = 0.0005), and other non-Caucasian ethnicity (RR = 6.9

[3.2-14.4]; P < 0.0001) were independently associated with HCC. Restricting

the analysis to HCV-related cirrhosis, the same risk factors remained

independently associated with HCC: age (decade; RR = 2.3 [1.6-3.4]; P <

0.0001), male gender (RR = 2.9 [1.2-7.0]; P = 0.02), African-American

ethnicity (RR = 3.1 [1.3-7.4]; P = 0.009), and other non-Caucasian ethnicity

(RR = 15.8 [1.9-134]; P = 0.01). Iron studies did not reveal an increased

risk for iron overload or HFE mutation. Male gender, advancing age, and

non-Caucasian ethnic background are independently associated with HCC.

PMID: 15259508 [PubMed - in process]

[Guest guest]

Dig Dis Sci. 2004 May;49(5):850-3.

Risk factors for hepatocellular carcinoma in patients with cirrhosis.

Sarbah SA, Gramlich T, Younoszai A, Osmack P, Goormastic M, Grosso L,

JN, Di Bisceglie A, Seneca R, Younossi ZM.

Center for Liver Diseases at Inova Fairfax Hospital, Falls Church, Virginia

22042, USA.

Recent research suggests an increase in the incidence of hepatocellular

carcinoma (HCC) in the United States, which may be related to an upsurge in

the sequelae of chronic liver disease from hepatitis C virus. In addition to

factors related to the underlying etiology of liver disease, a number of

host factors such as age, gender, and ethnic background may be associated

with this increased risk. The aim of this study was to evaluate a number of

potential risk factors for HCC in patients with cirrhosis. Patients with

biopsy proven HCC were identified from our pathology and cancer registry

databases. All those without histologic or clinical cirrhosis and non-HCC

hepatic malignancies were excluded. Cirrhotic patients without HCC were also

selected from the Cleveland Clinic unified transplant database and were

designated controls. Extensive clinicodemographic data were obtained from

the databases and chart reviews. When available, paraffin-embedded liver

biopsy blocks were obtained for HFE gene analysis. Univariate comparisons

were made with chi-square and Fisher's exact test and multivariate analysis

was carried out with logistic regression. A total of 760 patients were

included in this study, 244 documented cases of HCC and 516 cirrhotic

controls without HCC. Patients' age (RR = 3.1 [2.6-3.8]; P < 0.0001), male

gender (RR = 3.4 [2.3-5.1]; P < 0.0001), African-American ethnicity (RR =

3.1 [1.6-5.8]; P = 0.0005), and other non-Caucasian ethnicity (RR = 6.9

[3.2-14.4]; P < 0.0001) were independently associated with HCC. Restricting

the analysis to HCV-related cirrhosis, the same risk factors remained

independently associated with HCC: age (decade; RR = 2.3 [1.6-3.4]; P <

0.0001), male gender (RR = 2.9 [1.2-7.0]; P = 0.02), African-American

ethnicity (RR = 3.1 [1.3-7.4]; P = 0.009), and other non-Caucasian ethnicity

(RR = 15.8 [1.9-134]; P = 0.01). Iron studies did not reveal an increased

risk for iron overload or HFE mutation. Male gender, advancing age, and

non-Caucasian ethnic background are independently associated with HCC.

PMID: 15259508 [PubMed - in process]

[Guest guest]

Dig Dis Sci. 2004 May;49(5):850-3.

Risk factors for hepatocellular carcinoma in patients with cirrhosis.

Sarbah SA, Gramlich T, Younoszai A, Osmack P, Goormastic M, Grosso L,

JN, Di Bisceglie A, Seneca R, Younossi ZM.

Center for Liver Diseases at Inova Fairfax Hospital, Falls Church, Virginia

22042, USA.

Recent research suggests an increase in the incidence of hepatocellular

carcinoma (HCC) in the United States, which may be related to an upsurge in

the sequelae of chronic liver disease from hepatitis C virus. In addition to

factors related to the underlying etiology of liver disease, a number of

host factors such as age, gender, and ethnic background may be associated

with this increased risk. The aim of this study was to evaluate a number of

potential risk factors for HCC in patients with cirrhosis. Patients with

biopsy proven HCC were identified from our pathology and cancer registry

databases. All those without histologic or clinical cirrhosis and non-HCC

hepatic malignancies were excluded. Cirrhotic patients without HCC were also

selected from the Cleveland Clinic unified transplant database and were

designated controls. Extensive clinicodemographic data were obtained from

the databases and chart reviews. When available, paraffin-embedded liver

biopsy blocks were obtained for HFE gene analysis. Univariate comparisons

were made with chi-square and Fisher's exact test and multivariate analysis

was carried out with logistic regression. A total of 760 patients were

included in this study, 244 documented cases of HCC and 516 cirrhotic

controls without HCC. Patients' age (RR = 3.1 [2.6-3.8]; P < 0.0001), male

gender (RR = 3.4 [2.3-5.1]; P < 0.0001), African-American ethnicity (RR =

3.1 [1.6-5.8]; P = 0.0005), and other non-Caucasian ethnicity (RR = 6.9

[3.2-14.4]; P < 0.0001) were independently associated with HCC. Restricting

the analysis to HCV-related cirrhosis, the same risk factors remained

independently associated with HCC: age (decade; RR = 2.3 [1.6-3.4]; P <

0.0001), male gender (RR = 2.9 [1.2-7.0]; P = 0.02), African-American

ethnicity (RR = 3.1 [1.3-7.4]; P = 0.009), and other non-Caucasian ethnicity

(RR = 15.8 [1.9-134]; P = 0.01). Iron studies did not reveal an increased

risk for iron overload or HFE mutation. Male gender, advancing age, and

non-Caucasian ethnic background are independently associated with HCC.

PMID: 15259508 [PubMed - in process]

[Guest guest]

Dig Dis Sci. 2004 May;49(5):850-3.

Risk factors for hepatocellular carcinoma in patients with cirrhosis.

Sarbah SA, Gramlich T, Younoszai A, Osmack P, Goormastic M, Grosso L,

JN, Di Bisceglie A, Seneca R, Younossi ZM.

Center for Liver Diseases at Inova Fairfax Hospital, Falls Church, Virginia

22042, USA.

Recent research suggests an increase in the incidence of hepatocellular

carcinoma (HCC) in the United States, which may be related to an upsurge in

the sequelae of chronic liver disease from hepatitis C virus. In addition to

factors related to the underlying etiology of liver disease, a number of

host factors such as age, gender, and ethnic background may be associated

with this increased risk. The aim of this study was to evaluate a number of

potential risk factors for HCC in patients with cirrhosis. Patients with

biopsy proven HCC were identified from our pathology and cancer registry

databases. All those without histologic or clinical cirrhosis and non-HCC

hepatic malignancies were excluded. Cirrhotic patients without HCC were also

selected from the Cleveland Clinic unified transplant database and were

designated controls. Extensive clinicodemographic data were obtained from

the databases and chart reviews. When available, paraffin-embedded liver

biopsy blocks were obtained for HFE gene analysis. Univariate comparisons

were made with chi-square and Fisher's exact test and multivariate analysis

was carried out with logistic regression. A total of 760 patients were

included in this study, 244 documented cases of HCC and 516 cirrhotic

controls without HCC. Patients' age (RR = 3.1 [2.6-3.8]; P < 0.0001), male

gender (RR = 3.4 [2.3-5.1]; P < 0.0001), African-American ethnicity (RR =

3.1 [1.6-5.8]; P = 0.0005), and other non-Caucasian ethnicity (RR = 6.9

[3.2-14.4]; P < 0.0001) were independently associated with HCC. Restricting

the analysis to HCV-related cirrhosis, the same risk factors remained

independently associated with HCC: age (decade; RR = 2.3 [1.6-3.4]; P <

0.0001), male gender (RR = 2.9 [1.2-7.0]; P = 0.02), African-American

ethnicity (RR = 3.1 [1.3-7.4]; P = 0.009), and other non-Caucasian ethnicity

(RR = 15.8 [1.9-134]; P = 0.01). Iron studies did not reveal an increased

risk for iron overload or HFE mutation. Male gender, advancing age, and

non-Caucasian ethnic background are independently associated with HCC.

PMID: 15259508 [PubMed - in process]