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Hepatic and Extrahepatic Malignancies in Cirrhosis Caused by Nonalcoholic Steatohepatitis and Alcoholic Liver Disease
Author(s) -
Kodama Kazuhisa,
Tokushige Katsutoshi,
Hashimoto Etsuko,
Taniai Makiko,
Shiratori Keiko
Publication year - 2013
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/j.1530-0277.2012.01900.x
Subject(s) - hepatocellular carcinoma , cirrhosis , medicine , gastroenterology , steatohepatitis , alcoholic liver disease , liver cancer , nonalcoholic steatohepatitis , chronic liver disease , cancer , fatty liver , nonalcoholic fatty liver disease , disease
Background To clarify the carcinogenic factors associated with steatohepatitis, we investigated the characteristic features of hepatic and extrahepatic malignancies in patients with cirrhotic nonalcoholic steatohepatitis ( NASH ‐ LC ) and cirrhotic alcoholic liver disease ( ALD ‐ LC ). Methods A total of 72 patients with NASH ‐ LC and 85 with ALD ‐ LC (both biopsy‐proven steatohepatitis without hepatocellular carcinoma [HCC]) were assessed with regard to the development of hepatic and extrahepatic malignancies. Risk factors for HCC were analyzed. Results During follow‐up, 10 NASH ‐ LC patients and 6 ALD ‐ LC patients developed HCC . The 5‐year HCC development rate was similar for these 2 groups, being 10.5% in the NASH ‐ LC group and 12.3% in the ALD ‐ LC group. After adjusting for age and gender, the HCC development rates were also similar. Risk factors for HCC in the NASH ‐ LC group were older age, higher γ‐ GTP level, and higher C hild– P ugh score as determined by C ox hazards analysis. Regarding risk factors in the ALD ‐ LC group, no risk factor was found by C ox hazards analysis, although diabetes mellitus led to a significantly higher HCC rate by log‐rank test ( p = 0.013). Regarding extrahepatic cancer, only 1 NASH ‐ LC patient (1.4%) developed endometrial cancer. In contrast, 7 ALD ‐ LC patients (8.2%) had other cancers ( p = 0.052). Conclusions Comparison between NASH ‐ LC and ALD ‐ LC revealed similar HCC development curves. However, the risk factors for HCC and extrahepatic malignancies differed between the 2 diseases. In ALD ‐ LC , the incidences of HCC and extrahepatic cancer are similar. When treating LC patients with NASH or ALD , the risk factors and extrahepatic malignancies associated with ALD ‐ LC should be assessed.