The etiology of liver disease affects the features of hepatocellular carcinoma diagnosed during surveillance.
However, it is not known whether it influences patients' survival.
Dr Franco Trevisani and colleagues from Italy analyzed the impact of etiology on the characteristics and outcome of hepatocellular carcinoma detected during surveillance.
|Only age was associated with gross pathology|
|The American Journal of Gastroenterology|
The team undertook a cohort study of 742 patients with hepatocellular carcinoma detected during semiannual or annual surveillance.
The researchers also evaluated 1834 consecutive patients observed in 3 primary and 7 tertiary care settings for hepatocellular carcinoma.
Patients were grouped according to etiology.
The team identified 87 patients with Hepatitis B virus, and 461 with Hepatitis C virus.
The etiology for 59 patients was alcohol, and 135 had multietiology.
The researchers found that most hepatocellular carcinomas were unifocal and most of them were 3 cm.
Unifocal hepatocellular carcinomas were less common in the multietiology group, and slightly more frequent in the Hepatitis C virus group.
Besides etiology, the research team observed that only age was associated with gross pathology.
The researchers discovered about 75% of hepatocellular carcinomas in all groups at Cancer of the Liver Italyn Program stage 0 or 1.
The team found the 1-, 3-, and 5-year survival rates were comparable among groups.
The researchers noted that the surveillance interval did not influence survival.
Survival was independently predicted by serum a-fetoprotein, Child-Pugh class, gross pathology, cancer size, vascular invasion, and treatment.
Dr Trevisani's team concluded, "In patients with hepatocellular carcinoma diagnosed during surveillance, single nodules are less common in multietiology cases."
"Prognosis is independent of etiology, being dictated by liver function, oncologic features, and treatment."