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Risk and outcome of hepatocellular carcinoma in liver cirrhosis in Southern Sweden : a population-based study

Nilsson, Emma LU ; Anderson, Harald LU ; Sargenti, Konstantina LU ; Lindgren, Stefan LU and Prytz, Hanne LU (2019) In Scandinavian Journal of Gastroenterology
Abstract

Background and aims: Liver cirrhosis is a risk factor for hepatocellular carcinoma (HCC). While the HCC risk is thought to be highest in hepatitis B and hepatitis C, the risk in other cirrhosis etiologies is not fully established. Therefore, we aimed to study the risk and outcome of HCC in alcoholic cirrhosis compared to cirrhosis of other etiologies, in Sweden. Material and methods: We used population-based medical registries to identify patients diagnosed with cirrhosis in the Scania region in southern Sweden between 2001 and 2010. Medical records were reviewed to identify all HCC cases and to register clinical parameters. All patients were followed until death, emigration or December 2017. Results: The cohort comprised 1317 patients... (More)

Background and aims: Liver cirrhosis is a risk factor for hepatocellular carcinoma (HCC). While the HCC risk is thought to be highest in hepatitis B and hepatitis C, the risk in other cirrhosis etiologies is not fully established. Therefore, we aimed to study the risk and outcome of HCC in alcoholic cirrhosis compared to cirrhosis of other etiologies, in Sweden. Material and methods: We used population-based medical registries to identify patients diagnosed with cirrhosis in the Scania region in southern Sweden between 2001 and 2010. Medical records were reviewed to identify all HCC cases and to register clinical parameters. All patients were followed until death, emigration or December 2017. Results: The cohort comprised 1317 patients with cirrhosis. A total of 200 patient developed HCC, including 75 with prevalent HCC. The annual incidence of HCC after six months was 1.5% in alcoholic cirrhosis and 4.7% in hepatitis C cirrhosis. In alcoholic cirrhosis, 40 patients were diagnosed with HCC during follow-up, of which 15 patients fulfilled the Milan criteria and 10 received treatment, curative or palliative. The overall median survival after HCC diagnosis was 7.7 months, with 4.5, 11 and 9.3 months, in cirrhosis due to alcohol, hepatitis C or remaining causes, respectively. Conclusion: We find an annual incidence of HCC in alcoholic cirrhosis of 1.5% indicating need for surveillance in these patients. Survival after HCC diagnosis was worst in alcoholic cirrhosis due to more advanced stage at diagnosis with few patients eligible for treatment.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
alcohol, cirrhosis, decompensation, hepatitis C, hepatocellular carcinoma, population-based cohort, survival
in
Scandinavian Journal of Gastroenterology
publisher
Taylor & Francis
external identifiers
  • scopus:85070495925
ISSN
0036-5521
DOI
10.1080/00365521.2019.1649454
language
English
LU publication?
yes
id
7291a41a-99f5-4767-8af8-324eb407517c
date added to LUP
2019-08-22 13:44:31
date last changed
2019-09-17 04:59:17
@article{7291a41a-99f5-4767-8af8-324eb407517c,
  abstract     = {<p>Background and aims: Liver cirrhosis is a risk factor for hepatocellular carcinoma (HCC). While the HCC risk is thought to be highest in hepatitis B and hepatitis C, the risk in other cirrhosis etiologies is not fully established. Therefore, we aimed to study the risk and outcome of HCC in alcoholic cirrhosis compared to cirrhosis of other etiologies, in Sweden. Material and methods: We used population-based medical registries to identify patients diagnosed with cirrhosis in the Scania region in southern Sweden between 2001 and 2010. Medical records were reviewed to identify all HCC cases and to register clinical parameters. All patients were followed until death, emigration or December 2017. Results: The cohort comprised 1317 patients with cirrhosis. A total of 200 patient developed HCC, including 75 with prevalent HCC. The annual incidence of HCC after six months was 1.5% in alcoholic cirrhosis and 4.7% in hepatitis C cirrhosis. In alcoholic cirrhosis, 40 patients were diagnosed with HCC during follow-up, of which 15 patients fulfilled the Milan criteria and 10 received treatment, curative or palliative. The overall median survival after HCC diagnosis was 7.7 months, with 4.5, 11 and 9.3 months, in cirrhosis due to alcohol, hepatitis C or remaining causes, respectively. Conclusion: We find an annual incidence of HCC in alcoholic cirrhosis of 1.5% indicating need for surveillance in these patients. Survival after HCC diagnosis was worst in alcoholic cirrhosis due to more advanced stage at diagnosis with few patients eligible for treatment.</p>},
  author       = {Nilsson, Emma and Anderson, Harald and Sargenti, Konstantina and Lindgren, Stefan and Prytz, Hanne},
  issn         = {0036-5521},
  keyword      = {alcohol,cirrhosis,decompensation,hepatitis C,hepatocellular carcinoma,population-based cohort,survival},
  language     = {eng},
  month        = {08},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Gastroenterology},
  title        = {Risk and outcome of hepatocellular carcinoma in liver cirrhosis in Southern Sweden : a population-based study},
  url          = {http://dx.doi.org/10.1080/00365521.2019.1649454},
  year         = {2019},
}