The incidence of hepatocellular carcinoma (HCC) in the United States is increasing.
However, the clinical characteristics of American patients with HCC have not been well described.
|50% of patients with cryptogenic cirrhosis had features associated with nonalcoholic fatty liver disease.|
In this study, researchers sought to determine the etiology of liver disease and short-term outcome among HCC patients presenting to a single center in the United States.
The research team studied 105 consecutive patients with HCC. Their mean age was 59 years, 67% were men, and 76% were non-Hispanic white.
They identified the most common etiologies of liver disease as hepatitis C (51%) and cryptogenic cirrhosis (29%).
However, half the patients with cryptogenic cirrhosis had histologic or clinical features associated with nonalcoholic fatty liver disease (NAFLD).
Of the patients in the study, 50% patients had HCC detected during surveillance (group I), whereas the remaining 50% had symptomatic tumors (group II).
Overall, patients in group I had smaller tumors, were more likely to be eligible for surgical treatment, and had a better median survival, compared with patients in group II.
The team also found that patients with cryptogenic cirrhosis were less likely to have undergone HCC surveillance. These patients had larger tumors at diagnosis.
Dr Jorge Marrero's team at the University of Michigan, USA, concluded, "Hepatitis C and cryptogenic liver disease are the most common etiologies of diseases in our patients with HCC".
However, "NAFLD accounted for at least 13% of the cases".
"Patients who underwent surveillance had smaller tumors and were more likely to be candidates for surgical or local ablative therapies".
"Because of the increasing incidence of NAFLD, further studies are needed to determine the risk of HCC in patients with NAFLD".