The presence of hepatocellular carcinoma has important implications for patients with cirrhosis.
Studies have not compared the risk of cancer in cirrhotic patients with small liver nodules to cirrhotic patients without nodules.
Dr Mark Russo and colleagues from North Carolina determined the risk of hepatocellular carcinoma in cirrhotic patients.
The investigative team compared those with small liver nodules on magnetic resonance imaging to those without nodules.
The team conducted a prospective study to determine the rate of hepatocellular carcinoma in cirrhotic patients with and without liver nodules.
Cases were patients with liver nodules less than 2 cm on magnetic resonance imaging, and controls were cirrhotic patients without nodules.
The team performed Kaplan-Meier estimates and multivariate analysis to estimate the risk of hepatocellular carcinoma in the 2 groups.
| There was a 25 times higher risk for hepatocellular carcinoma in the liver nodule group vs controls|
|American Journal of Gastroenterology|
A total of 310 liver transplant candidates with a mean follow-up of 663 days were included in the study and 133 underwent liver transplant during follow-up.
The team found that the 1-year incidence of hepatocellular carcinoma in the liver nodule group and control group was 11% and about 1%, respectively.
The investigators noted that the adjusted risk for hepatocellular carcinoma in the liver nodule group was 25 times higher compared to the control group.
In candidates who underwent transplant with or without nodules, the rate of hepatocellular carcinoma was 50% and 4%, respectively.
Dr Russo's team commented, “The incidence of hepatocellular carcinoma in patients with small liver nodules is significantly higher compared to patients with cirrhosis without liver nodules.”
“The presence of small liver nodules warrants increased imaging surveillance for hepatocellular carcinoma.”