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NAFLD may be a common underlying liver disease in patients with hepatocellular Carcinoma in the United States
Author(s) -
Marrero Jorge A.,
Fontana Robert J.,
Su Grace L.,
Conjeevaram Hari S.,
Emick Dawn M.,
Lok Anna S.
Publication year - 2002
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840360609
Subject(s) - medicine , hepatocellular carcinoma , cirrhosis , nonalcoholic fatty liver disease , gastroenterology , etiology , incidence (geometry) , liver disease , hepatitis c , hepatitis b , fatty liver , viral hepatitis , disease , physics , optics
The incidence of hepatocellular carcinoma (HCC) in the United States is increasing, but the clinical characteristics of American patients with HCC have not been well described. The aims of this study were to determine the etiology of liver disease and short‐term outcome among HCC patients presenting to a single center in the United States. One hundred five consecutive patients with HCC were studied; mean age was 59 years, 67% were men, and 76% were non‐Hispanic white. The most common etiology of liver disease was hepatitis C (51%) and cryptogenic cirrhosis (29%). Half of the patients with cryptogenic cirrhosis had histologic or clinical features associated with nonalcoholic fatty liver disease (NAFLD). Fifty‐three (50%) patients had HCC detected during surveillance (group I), whereas the remaining patients had symptomatic tumors (group II). Group I patients had smaller tumors ( P = 0.01), were more likely to be eligible for surgical treatment ( P = 0.005), and had a better medican survival compared with patients in group II ( P = 0.001). Patients with cryptogenic cirrhosis were less likely to have undergone HCC surveillance and had larger tumors at diagnosis. In conclusion, hepatitis C and cryptogenic liver disease are the most common etiologies of diseases in our patients with HCC. 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. (H EPATOLOGY 2002;36:1349‐1354).