Incidence and risk factors for hepatocellular carcinoma in 967 patients with cirrhosis.
OBJECTIVE
To determine the incidence of hepatocellular carcinoma in cirrhosis and to examine the influence of age and sex, and the contribution of etiological factors.


METHODS
967 patients with liver cirrhosis and free of hepatocellular carcinoma were enrolled in this longitudinal, retrospective and observational study. Monitoring for hepatocellular carcinoma was scheduled at 3- to 6-month intervals. The mean (+/-SD) length of follow-up was 60.3+/-51.7 months (range 6 258).


RESULTS
During the observation period, hepatocellular carcinoma developed in 64 patients. The calculated annual incidence was 2.1%. The probability of being free of liver cancer was 92% at 5 years, 80% at 10 years, and 69% at 15 years. Age was the only independent risk factor for the development of malignancy in the multivariate analysis. There were no differences according to male sex, alcohol abuse, and chronic hepatitis B and C virus infection.


CONCLUSIONS
The annual incidence of hepatocellular carcinoma was 2.1%. These results, although confirming that age is a risk factor for hepatocellular carcinoma in cirrhosis, indicate that alcohol abuse, male sex, and concurrent hepatitis B and C virus infection do not involve a higher risk of developing liver cancer.
del Olmo
J A
JA
Service of Hepatology, Hospital Clínico Universitario, Valencia, Spain.
Serra
M A
MA
Rodríguez
F
F
Escudero
A
A
Gilabert
S
S
Rodrigo
J M
JM
D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D016174:Hepacivirus; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology; D006515:Hepatitis B virus; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000150:complications / Q000453:epidemiology* / Q000209:etiology; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications / Q000453:epidemiology; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors