4 years ago

More advanced disease and worse survival in cryptogenic compared to viral hepatocellular carcinoma

Ming-Lun Yeh, Chung-Feng Huang, Mindie H. Nguyen, Vincent L. Chen, Chia-Yen Dai, Ju Dong Yang, Ming-Lung Yu, Wan-Long Chuang, Pauline Nguyen, Tomi W. Jun, Lewis R. Roberts, Ann W. Hsing, Nasra H. Giama, Jee-Fu Huang
Background & Aims Although hepatitis B virus (HBV) and hepatitis C virus (HCV) infections remain major risk factors for hepatocellular carcinoma (HCC), non-viral causes of HCC, particularly non-alcoholic fatty liver disease, are becoming increasingly prevalent. The aim of this study was to compare the clinical characteristics and survival of cryptogenic and viral HCC. Methods We conducted a retrospective cohort study involving 3,878 consecutive HCC patients seen at two tertiary centers in the United States and one in Taiwan from 2004-2014. We compared the clinical characteristics, treatment and survival of patients by underlying etiology: cryptogenic (n=696), HBV (n=1,304), or HCV (n=1,878). Results Cirrhosis was present in 66.8% of the cryptogenic HCC patients, compared with 74.7% of HBV-HCC (p=0.001) and 85.9% of HCV-HCC (p<0.001). Compared to viral HCC, cryptogenic HCC patients presented with larger tumors and at later stages of disease. Five-year overall survival was 16.3% among cryptogenic HCC patients compared with 31.9% among HBV-HCC patients and 27.7% among HCV-HCC patients (p<0.001 for both by the log-rank test). HCC etiology was not an independent predictor of survival, though ethnicity, cirrhosis status, meeting Milan criteria and treatment allocation were. Conclusions Compared with viral HCC patients, those with cryptogenic HCC had lower prevalence of cirrhosis, were diagnosed with larger tumors at more advanced stages of disease, and had poorer overall survival. Additional efforts are needed to identify patients at risk of cryptogenic HCC and to identify cryptogenic HCC at earlier stages of disease. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/liv.13613

You might also like
Discover & Discuss Important Research

Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.